title: Preoperative assessment of intestinal endometriosis: A comparison of transvaginal sonography with water-contrast in the rectum, transrectal sonography, and barium enema.
abstract: To evaluate the accuracy of Transrectal Sonography (TRS) and a new technique, Transvaginal Sonography with Water-Contrast in the Rectum (RWC-TVS), in the diagnosis of rectosigmoid endometriosis, and the accuracy of Barium Enema (BE) and RWC-TVS in the detection of intestinal stenosis due to endometriosis. In a prospective study, we compared the findings of TRS and RWC-TVS performed before surgery with the operative and pathologic findings in 61 consecutive patients who underwent laparoscopy or laparotomy for suspected rectosigmoid endometriosis. The accuracy of BE and RWC-TVS in the detection of intestinal stenosis was evaluated comparing the radiologic and ultrasonographic results with the macroscopic findings at surgery and pathology. RWC-TVS diagnosed rectosigmoid endometriosis with the same accuracy of TRS and was equally efficient as BE in the detection of a significant intestinal lumen stenosis. For the diagnosis of rectosigmoid endometriosis the sensitivity, specificity, positive and negative predictive values of TRS and RWC-TVS were 88.2% and 96%, 80%, and 90%, 95.7%, and 98%, and 57.1% and 81.8%, respectively. For the detection of intestinal stenosis the sensitivity, specificity, positive and negative predictive values of BE and RWC-TVS were 93.7% and 87.5%, 94.2% and 91.4%, 88.2% and 82.3%, and 97% and 94.1%, respectively. RWC-TVS is a new, simple technique for a single-step and accurate preoperative assessment of rectosigmoid endometriosis.
authors.affiliation: Department of Obstetrics and Gynecology, University of Verona, Italy. valentino.bergamini@gmail.com
authors.forename: Valentino
authors.initials: V
authors.lastname: Bergamini
authors.forename: Fabio
authors.initials: F
authors.lastname: Ghezzi
authors.forename: Stefano
authors.initials: S
authors.lastname: Scarperi
authors.forename: Ricciarda
authors.initials: R
authors.lastname: Raffaelli
authors.forename: Antonella
authors.initials: A
authors.lastname: Cromi
authors.forename: Massimo
authors.initials: M
authors.lastname: Franchi
mesh_terms: D000328:Adult; D001466:Barium Sulfate; D016009:Chi-Square Distribution; D012809:Colon, Sigmoid / Q000473:pathology* / Q000601:surgery; D003287:Contrast Media; D004715:Endometriosis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D004733:Enema; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D010535:Laparoscopy; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012007:Rectum / Q000473:pathology* / Q000601:surgery; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D014621:Vagina
chemical_list: D003287:Contrast Media; D001466:Barium Sulfate