title: Diagnosis of endometriosis of the rectovaginal septum using introital three-dimensional ultrasonography.
abstract: OBJECTIVE
  To evaluate the diagnostic accuracy of introital three-dimensional (3D) transvaginal sonography for preoperative detection of rectovaginal septal endometriosis.
  
  
  METHODS
  Ultrasonographic results were compared with surgical and histologic findings.
  
  
  METHODS
  University Department of Obstetrics and Gynecology.
  
  
  METHODS
  This prospective study included 39 women with suspected rectovaginal endometriosis.
  
  
  METHODS
  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.
  
  
  METHODS
  Sensitivity, specificity, and likelihood ratios (positive or negative) were calculated with 95% confidence intervals (CIs).
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Obstetrics, Gynecology, and Reproduction, Institut Universitari Dexeus, University of Barcelona, Barcelona, Spain.
authors.forename: Maria Angela
authors.initials: MA
authors.lastname: Pascual
authors.forename: Stefano
authors.initials: S
authors.lastname: Guerriero
authors.forename: Lourdes
authors.initials: L
authors.lastname: Hereter
authors.forename: Pedro
authors.initials: P
authors.lastname: Barri-Soldevila
authors.forename: Silvia
authors.initials: S
authors.lastname: Ajossa
authors.forename: Betlem
authors.initials: B
authors.lastname: Graupera
authors.forename: Ignacio
authors.initials: I
authors.lastname: Rodriguez
mesh_terms: D000328:Adult; D004715:Endometriosis / Q000000981:diagnostic imaging* / Q000601:surgery; D019160:Endosonography / Q000379:methods*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D010535:Laparoscopy / Q000379:methods; D011237:Predictive Value of Tests; D012002:Rectal Diseases / Q000000981:diagnostic imaging* / Q000601:surgery; D012007:Rectum / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity; D014621:Vagina / Q000000981:diagnostic imaging; D014623:Vaginal Diseases / Q000000981:diagnostic imaging* / Q000601:surgery