OP19.09: Clinical history of recto‐sigmoid endometriosis: a 6‐years follow‐up study

To observe the clinical history of pre-menopausal women with recto-sigmoid deep infiltrating endometriosis (DIE) diagnosed by 3D-transvaginal sonography (3D-TVS) with Volume Contrast Imaging (VCI) analysis. Consecutive pre-menopausal women with recto-sigmoid DIE were prospectively enrolled. 3D-TVS was performed with the GE Voluson 730 unit, using a wide-band 3–9 MHz transducer. Compound Resolution Imaging (CRI) and Speckle Reduction Imaging (SRI) technologies were used to optimize image before volume acquisition by enhancing contrast resolution and reducing artifacts and speckle. VCI analysis by 2 mm slices of the stored 3D multiplanar examinations was considered for the evaluation of the depth of wall infiltration of intestinal DIE. Demographic, medical, imaging (X-ray Barium Enema (X-ray BE), 3D-TVS) and surgical data were recorded. Surgery and/or MRI were considered the gold standard. Up to 120 patients were enrolled. Median age was 35 (IR 32–40) years. Up to 75% of patients were symptomatic. In the follow-up study period 11 spontaneous pregnancies and 3 ART-derived occurred. 3 patients underwent bowel resection with one relapsed after 24 months. Medical therapy by continous oral contraceptives and/or LNG-IUS permitted to control pain in most of symptomatic patients. 3D-TVS adequately diagnoses recto-sigmoid DIE. VCI analysis might permit to improve operator confidence in patients with recto-sigmoid endometriosis. A sonographic-based triage might help in a long-term medical treatment of recto-sigmoid DIE.