Transvaginal ultrasonography with water-contrast in the rectum in the diagnosis of bowel endometriosis.
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Abstract
AIM: The rectosigmoid is the most frequent location of intestinal endometriosis. Although several techniques have been proposed for the diagnosis of intestinal endometriosis, no gold standard is currently available. In this review, we describe in details a new technique for the diagnosis of rectosigmoid endometriosis: rectal water-contrast transvaginal ultrasonography. METHODS: During transvaginal ultrasonography, an assistant inserts a 6-mm flexible catheter through the anal os into the rectal lumen; the insertion of this catheter is evaluated under ultrasonographic control. Water contrast is instilled slowly in the rectum to permit intestinal distension. The colonic wall evaluation is obtained by positioning the transvaginal probe against a length of the sigmoid colon to obtain either axial or longitudinal images. The injection of the saline solution facilitates the identification of recto-sigmoid endometriotic nodules which appear as rounded or triangular hypoechoic masses, located anterior or lateral to the bowel. RESULTS: This technique has high sensitivity and specificity in the diagnosis of rectal infiltration in women with rectovaginal endometriosis. The distance between the nodules and the mucosal layer permits to estimate the depth of infiltration of these endometriotic lesions within the intestinal wall. Rectal distensibility can be estimated. The procedure is well tolerated by the patients. CONCLUSION: Water distension of the rectum facilitates the identification of intestinal endometriosis during transvaginal ultrasonography.
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Cited by (15)
- Transvaginal Ultrasound in the Diagnosis and Assessment of Endometriosis-An Overview: How, Why, and When 2022
- Does Bowel Preparation Improve the Performance of Rectal Water Contrast Transvaginal Ultrasonography in Diagnosing Rectosigmoid Endometriosis? 2018
- Efficacy and acceptability of long-term norethindrone acetate for the treatment of rectovaginal endometriosis 2017
- Diagnostic laparoscopy in pre‐surgical planning for higher stage endometriosis: Is it still relevant? 2016
- Systematic Evaluation of Women With Suspected Endometriosis Using a 5‐Domain Sonographically Based Approach 2015
- Dienogest in women with persistent endometriosis-related pelvic pain during norethisterone acetate treatment 2014
- Office gel sonovaginography for the prediction of posterior deep infiltrating endometriosis: a multicenter prospective observational study 2014
- Bowel Endometriosis: An Overview 2014
- The ‘sliding sign’ in conjunction with sonovaginography: is this the optimal approach for the diagnosis of Pouch of Douglas obliteration and posterior compartment deep infiltrating endometriosis? 2013
- O475 PROGESTOGEN‐ONLY CONTRACEPTIVE PILL COMPARED WITH COMBINED ORAL CONTRACEPTIVE IN THE TREATMENT OF PAIN SYMPTOMS CAUSED BY ENDOMETRIOSIS IN PATIENTS WITH MIGRAINE WITHOUT AURA 2012
- Prediction of pouch of Douglas obliteration in women with suspected endometriosis using a new real-time dynamic transvaginal ultrasound technique: the sliding sign 2012
- Letrozole and norethisterone acetate versus letrozole and triptorelin in the treatment of endometriosis related pain symptoms: a randomized controlled trial 2011
- The use of intra‐operative saline sonovaginography to define the rectovaginal septum in women with suspected rectovaginal endometriosis: a pilot study 2011
- Bowel endometriosis: Recent insights and unsolved problems 2011
- Sonovaginography: redefining the concept of a “normal pelvis” on transvaginal ultrasound pre‐laparoscopic intervention for suspected endometriosis 2011
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