Does transvaginal ultrasonography combined with water-contrast in the rectum aid in the diagnosis of rectovaginal endometriosis infiltrating the bowel? -- Valenzano Menada et al., 10.1093 humrep den057
The Author 2008. Published by Oxford University Press on behalf of the European Homeland of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions oxfordjournals.org Does transvaginal ultrasonography combined with water-contrast in the rectum support in the diagnosis of rectovaginal endometriosis infiltrating the bowel?
M. Valenzano Menada, V. Remorgida, L.H. Abbamonte, A. Nicoletti, N. Ragni and S. Ferrero 1 Branch of Obstetrics and Gynaecology, San Martino Hospital, University of Genoa, Largo R. Benzi 1, 16132 Genoa, Italy 1 Dispatch address.
Tel: +39-010-511525 +39-3477211682; Fax: +39-010-511525; E-mail: dr at simoneferrero.com BACKGROUND: The objective of this glance at was to drive if adding water-contrast in the rectum during transvaginal ultrasonography (RWC-TVS) improves the diagnosis of rectal infiltration in women with rectovaginal endometriosis. METHODS: This prospective scan included 90 women, with suspect rectovaginal endometriosis, who underwent operative laparoscopy.
TVS and RWC-TVS were independently performed by disparate investigators. RWC-TVS was performed by injecting saline meaning into the rectal lumen under ultrasonographic dominion on ice a 6-mm catheter. Presence of rectovaginal nodules, presence and measure of rectal infiltration, and the largest breadth of the bowel nodules were evaluated. Ultrasonographic results were compared to surgical and histological findings.
RESULTS: Although RWC-TVS had higher correctness than TVS in diagnosing rectovaginal endometriosis, the digression between the two techniques was not statistically significant.
RWC-TVS was significantly deeper accurate than TVS in determining the presence of endometriotic infiltration reaching at least the muscular layer of the rectal wall. The sensitivity of RWC-TVS in identifying rectal lesions was 97%, the specificity 100%, the certain predictive price 100% and the contradiction predictive bill 91.3%. RWC-TVS caused a higher intensity of bitterness than TVS.
CONCLUSIONS: RWC-TVS determines the presence of rectovaginal nodules infiltrating the rectal muscularis propria aggrandized accurately than TVS; RWC-TVS could be used when TVS cannot exclude the presence of rectal infiltration. Fundamental words: diagnosis laparoscopy rectal endometriosis rectovaginal endometriosis transvaginal ultrasonography Submitted on Dec 25, 2007; resubmitted on Jan 30, 2008; usual on Feb 7, 2008.
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