Preoperative assessment of intestinal endometriosis: a comparison of Transvaginal Sonography with Water-Contrast in the Rectum, Transrectal Sonography, and Barium Enema

Bergamini V, Valentino Bergamini, Fabio Ghezzi, Scarperi S, Stefano Scarperi, Ricciarda Raffaelli, Antonella Cromi, Cromi A, Massimo Piergiuseppe Franchi, Massimo Franchi
Abdominal imaging · 2010 · vol. 35(6) , pp. 732–736 · doi:10.1007/s00261-010-9610-z · PMID:20364253 · W2022437596
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-28 ⓘ

Transvaginal sonography with water-contrast in the rectum is as accurate as transrectal sonography for diagnosing rectosigmoid endometriosis and as effective as barium enema for detecting intestinal stenosis.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This paper studied the diagnostic accuracy of transrectal sonography (TRS) and a new technique, transvaginal sonography with water-contrast in the rectum (RWC-TVS), for rectosigmoid endometriosis, and the accuracy of barium enema (BE) and RWC-TVS for detecting intestinal stenosis due to endometriosis. In a prospective study of 61 consecutive patients undergoing laparoscopy or laparotomy for suspected rectosigmoid endometriosis, preoperative imaging results were compared with operative and pathologic findings. RWC-TVS achieved the same diagnostic accuracy as TRS for rectosigmoid endometriosis and was equally efficient as BE for detecting significant intestinal lumen stenosis, with reported sensitivities/specificities showing strong performance for both tasks. This paper does not explicitly discuss limitations in the provided text, but it evaluates only rectosigmoid disease in a single prospective surgical cohort, which may constrain generalizability. This paper is centrally about endometriosis — it compares RWC-TVS, TRS, and BE for preoperative assessment of rectosigmoid intestinal endometriosis and related stenosis.

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Abstract

To evaluate the accuracy of Transrectal Sonography (TRS) and a new technique, Transvaginal Sonography with Water-Contrast in the Rectum (RWC-TVS), in the diagnosis of rectosigmoid endometriosis, and the accuracy of Barium Enema (BE) and RWC-TVS in the detection of intestinal stenosis due to endometriosis. In a prospective study, we compared the findings of TRS and RWC-TVS performed before surgery with the operative and pathologic findings in 61 consecutive patients who underwent laparoscopy or laparotomy for suspected rectosigmoid endometriosis. The accuracy of BE and RWC-TVS in the detection of intestinal stenosis was evaluated comparing the radiologic and ultrasonographic results with the macroscopic findings at surgery and pathology. RWC-TVS diagnosed rectosigmoid endometriosis with the same accuracy of TRS and was equally efficient as BE in the detection of a significant intestinal lumen stenosis. For the diagnosis of rectosigmoid endometriosis the sensitivity, specificity, positive and negative predictive values of TRS and RWC-TVS were 88.2% and 96%, 80%, and 90%, 95.7%, and 98%, and 57.1% and 81.8%, respectively. For the detection of intestinal stenosis the sensitivity, specificity, positive and negative predictive values of BE and RWC-TVS were 93.7% and 87.5%, 94.2% and 91.4%, 88.2% and 82.3%, and 97% and 94.1%, respectively. RWC-TVS is a new, simple technique for a single-step and accurate preoperative assessment of rectosigmoid endometriosis.
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Abstract

To evaluate the accuracy of Transrectal Sonography (TRS) and a new technique, Transvaginal Sonography with Water-Contrast in the Rectum (RWC-TVS), in the diagnosis of rectosigmoid endometriosis, and the accuracy of Barium Enema (BE) and RWC-TVS in the detection of intestinal stenosis due to endometriosis. In a prospective study, we compared the findings of TRS and RWC-TVS performed before surgery with the operative and pathologic findings in 61 consecutive patients who underwent laparoscopy or laparotomy for suspected rectosigmoid endometriosis. The accuracy of BE and RWC-TVS in the detection of intestinal stenosis was evaluated comparing the radiologic and ultrasonographic results with the macroscopic findings at surgery and pathology. RWC-TVS diagnosed rectosigmoid endometriosis with the same accuracy of TRS and was equally efficient as BE in the detection of a significant intestinal lumen stenosis. For the diagnosis of rectosigmoid endometriosis the sensitivity, specificity, positive and negative predictive values of TRS and RWC-TVS were 88.2% and 96%, 80%, and 90%, 95.7%, and 98%, and 57.1% and 81.8%, respectively. For the detection of intestinal stenosis the sensitivity, specificity, positive and negative predictive values of BE and RWC-TVS were 93.7% and 87.5%, 94.2% and 91.4%, 88.2% and 82.3%, and 97% and 94.1%, respectively. RWC-TVS is a new, simple technique for a single-step and accurate preoperative assessment of rectosigmoid endometriosis. Similar content being viewed by others

References

Bergqvist A (1993) Different types of extragenital endometriosis: a review. Gynecol Endocrinol 7:207–221 Weed JC, Ray JE (1987) Endometriosis of the bowel. Obstet Gynecol 69:727–730 Prystowsky JB, Stryker SJ, Ujiki GT, Poticha SM (1988) Gastrointestinal endometriosis. Incidence and indications for resection. Arch Surg 123:855–858 Coronado C, Franklin RR, Lotze EC, Bailey HR, Valdés CT (1990) Surgical treatment of symptomatic colorectal endometriosis. Fertil Steril 53:411–416 Bailey HR, Ott MT, Hartendorp P (1994) Aggressive surgical management for advanced colorectal endometriosis. Dis Colon Rectum 37:747–753 Verspyck E, Lefranc JP, Guyard B, Blondon J (1997) Treatment of bowel endometriosis: a report of six cases of colorectal endometriosis and a survey of the literature. Eur J Obst Gynecol Repr Biol 71:81–84 Itoga T, Matsumoto T, Takeuchi H, et al. (2003) Fibrosis and smooth muscle metaplasia in rectovaginal endometriosis. Pathol Int 53:371–375 Fedele L, Bianchi S, Portuese A, Borruto F, Dorta M (1998) Transrectal ultrasonography in the assessment of rectovaginal endometriosis. Obstet Gynecol 91:444–448 Chapron C, Dumontier I, Dousset B, et al. (1998) Results and role of rectal endoscopic ultrasonography for patients with deep pelvic endometriosis. Hum Reprod 13(8):2266–2270 Bazot M, Detchev R, Cortez A, et al. (2003) Transvaginal sonography and rectal endoscopic sonography for the assessment of pelvic endometriosis: a preliminary comparison. Hum Reprod 18(8):1686–1692 Valenzano Menada M, Remorgida V, Abbamonte LH, et al. (2008) Hum Reprod 23(5):1069–1075 Laufer I (1994) Barium studies. In: Gore RM, Levine MS (eds) Textbook of gastrointestinal radiology. Philadelphia: W.B. Saunders, pp 1028–1040 Koga K, Osuga Y, Yano T, et al. (2003) Characteristic images of deeply infiltrating rectosigmoid endometriosis on transvaginal and transrectal ultrasonography. Hum Reprod 18(6):1328–1333 Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Bergamini, V., Ghezzi, F., Scarperi, S. et al. Preoperative assessment of intestinal endometriosis: a comparison of Transvaginal Sonography with Water-Contrast in the Rectum, Transrectal Sonography, and Barium Enema. Abdom Imaging 35, 732–736 (2010). https://doi.org/10.1007/s00261-010-9610-z Published: Issue date: DOI: https://doi.org/10.1007/s00261-010-9610-z

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Condition tags

endometriosis

MeSH descriptors

Colon, Sigmoid Endometriosis Intestinal Diseases Rectum Adult Barium Sulfate Chi-Square Distribution Colon, Sigmoid Colon, Sigmoid Contrast Media Endometriosis Endometriosis Endometriosis Enema Female Humans Intestinal Diseases Intestinal Diseases Intestinal Diseases Laparoscopy

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