Initial Accuracy of and Learning Curve for Transvaginal Ultrasound with Bowel Preparation for Deep Endometriosis in a US Tertiary Care Center

Scott W. Young, Dahiya N, Nirvikar Dahiya, Maitray D. Patel, Abrao MS, Mauricio S Abrao, Maurício Simões Abrão, Magrina JF, Javier F. Magrina, M’hamed Temkit, Temkit M, M'hamed Temkit, Kho RM, Rosanne M. Kho
Journal of Minimally Invasive Gynecology · 2017 · vol. 24(7) , pp. 1170–1176 · doi:10.1016/j.jmig.2017.07.002 · PMID:28694166 · W2724712004
article OA: closed CC0 ⤵ 30 in-corpus citations
View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-20 ⓘ

This study evaluated the initial accuracy and learning curve of transvaginal ultrasound with bowel preparation for diagnosing deep endometriosis at a US tertiary care center.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

Abstract

Study objectiveTo evaluate the diagnostic accuracy and learning curve of a sonographic mapping protocol for deep endometriosis (DE).DesignRetrospective cohort study (Canadian Task Force classification II-3).SettingTertiary referral center in the United States.Patients117 consecutive patients who presented to our gynecology clinic with complaints of significant noncyclic pelvic pain of at least 6 months' duration, and/or clinical findings concerning for deep endometriosis and who were referred for transvaginal ultrasound with bowel preparation.InterventionsPatients underwent transvaginal ultrasound with bowel-preparation (TVUS-BP) performed by a single radiologist. Findings suspicious for DE were reported and correlated with surgical and histopathological findings. The duration of the examination and number of cases required to achieve proficiency were calculated for positive, equivocal, and negative findings.Measurements and main resultsAmong 117 patients (median age, 35 years; range, 19-54 years) referred for TVUS-BP, 113 had complete examinations. Fifty-seven of these 113 patients underwent surgical exploration within 1 year, and DE was identified surgically in 23 of them. DE of the rectosigmoid colon and/or rectovaginal septum was detected with a sensitivity of 94% (95% confidence interval [CI], 70%-100%) and specificity of 100% (95% CI, 91%-100%). DE of the retrocervical region and/or uterosacral ligaments was detected with a sensitivity of 86% (95% CI, 65%-97%) and specificity of 94% (95% CI, 81%-99%). Proficiency, defined by a flattening of the learning curve, was achieved after 70 to 75 scans. The mean duration of the examination was 42 ± 4 minutes initially, but declined to 15 ± 4 minutes once proficiency was achieved. Cases of equivocal or minimal disease demonstrated the greatest decline in examination duration.ConclusionA newly applied TVUS-BP protocol for detection of pelvic DE is highly accurate and required only a modest learning curve to achieve procedural proficiency in a US tertiary referral center where physicians interpret but typically do not perform TVUS exams. Overcoming diagnostic uncertainty regarding minimal or equivocal disease appeared to be an important factor in the initial learning curve. With adequate training, TVUS-BP may be adapted as a primary diagnostic tool for detecting pelvic DE.

My notes (saved in your browser only)

Condition tags

endometriosis

MeSH descriptors

Cathartics Endometriosis Endometriosis Endosonography Learning Curve Peritoneal Diseases Preoperative Care Vagina Adult Cathartics Colon, Sigmoid Colon, Sigmoid Colon, Sigmoid Colon, Sigmoid Education, Medical Education, Medical Endometriosis Endometriosis Endosonography Female

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (26)

Cited by (27)

Source provenance

europepmc
last seen: 2026-09-20T09:27:46.357103+00:00
openalex
last seen: 2026-06-10T17:14:06.276822+00:00
pubmed
last seen: 2026-05-13T22:20:19.560968+00:00
License: CC0 · commercial use OK