P10.10: Rectal‐water contrast‐transvaginal ultrasonography (2D‐RWC‐TVS) versus 3D‐RWC‐TVS in the diagnosis of rectosigmoid endometriosis

This study aims to compare the performance of bidimensional rectal-water contrast-transvaginal ultrasonography (2D-RWC-TVS) with 3D-RWC-TVS for investigating the presence and characteristics of rectosigmoid endometriosis. This prospective study included 72 women of reproductive age with pain and intestinal complaints suggestive of rectosigmoid endometriosis. 2D- and 3D-RWC-TVS were independently and blindly performed by different ultrasonographers. A flexible catheter was introduced into the rectal lumen; up to 300 mL of sterile saline solution was injected into the rectosigmoid. The results of the two exams were compared with surgical findings and histology. The mean (± SD) age of the study population was 33.6 ± 5.2 years. At the time of the study, 40 women (55.5%) were under hormonal therapies. 44 patients (61.1%) had rectosigmoid endometriosis at surgery. The McNemar's test demonstrated that 2D- and 3D-RWC-TVS had similar performance in the diagnosis of rectosigmoid endometriosis (p = 0.130). The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio of 2D-RWC-TVS and 3D-RWC-TVS were respectively 90.9% (95% CI, 78.3%-97.5%), 78.6% (59.1%-91.8%), 87.0% (76.5%-93.2%), 84.6% (68.0%-93.5%), 4.2 (2.1-8.9), 0.1 (0.0-0.3) and 86.4% (72.6%-94.8%), 85.7% (67.3%-96.0%), 90.5% (79.2%-96.0%), 80.0% (65.2%-89.5%), 6.1 (2.4-15.1), 0.2 (0.1-0.3). Overall, there was no significant difference in the accuracy of 2D-RWC-TVS and 3D-RWC-TVS in estimating the volume of the largest intestinal nodule (p = 0.524) and in estimating the distance between endometriotic bowel nodules and the anal verge (p = 0.860). Despite being both feasible and well tolerated, 3D-RWC-TVS does not seem to improve the performance of 2D-RWC-TVS in the diagnosis of rectosigmoid endometriosis. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.