Diagnosis of endometriosis of the rectovaginal septum using introital three-dimensional ultrasonography

Maria Angela Pascual, M. Pascual, Stefano Guerriero, S. Guerriero, Lourdes Hereter, Hereter L, L. Hereter, Pere Barri-Soldevila, Pedro Barri-Soldevila, S. Ajossa, Silvia Ajossa, Ajossa S, Betlem Graupera, Graupera B, B. Graupera, Ignacio Rodriguez, Ignacio Rodríguez
Fertility and sterility · 2010 · vol. 94(7) , pp. 2761–2765 · doi:10.1016/j.fertnstert.2010.02.050 · PMID:20356583 · W2001714566
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This study investigated the diagnostic accuracy of introital three-dimensional ultrasonography for rectovaginal septum endometriosis.

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Abstract

ObjectiveTo evaluate the diagnostic accuracy of introital three-dimensional (3D) transvaginal sonography for preoperative detection of rectovaginal septal endometriosis.DesignUltrasonographic results were compared with surgical and histologic findings.SettingUniversity Department of Obstetrics and Gynecology.Patient(s)This prospective study included 39 women with suspected rectovaginal endometriosis.Intervention(s)All patients underwent 3D transvaginal sonography for the evaluation of the rectovaginal septum, before undergoing laparoscopic radical resection of endometriosis. Rectovaginal endometriosis was defined as hypoechoic areas, nodules, or anatomic distortion of this specific location.Main outcome measure(s)Sensitivity, specificity, and likelihood ratios (positive or negative) were calculated with 95% confidence intervals (CIs).Result(s)Surgery associated with histopathologic evaluation revealed deep endometriosis in the rectovaginal septum in 19 patients. The specificity, sensitivity, positive likelihood ratio, and negative likelihood ratio were 94.7% (95% CI, 78.6%-99.7%), 89.5% (95% CI, 73.3%-94.5%), 17.2 (95% CI, 2.51-115), and 0.11 (95% CI, 0.03-0.41), respectively.Conclusion(s)Introital 3D ultrasonography seems to be an effective method for the diagnosis of endometriosis of the rectovaginal septum and should be included in the preoperative evaluation of patients with clinical suspicion of deep endometriosis.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Endosonography Imaging, Three-Dimensional Imaging, Three-Dimensional Rectal Diseases Vaginal Diseases Adult Endometriosis Endometriosis Endosonography Female Gynecologic Surgical Procedures Gynecologic Surgical Procedures Humans Laparoscopy Laparoscopy Predictive Value of Tests Rectal Diseases Rectal Diseases Rectum

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