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Transvaginal sonography with vs without bowel preparation in diagnosis of rectosigmoid endometriosis: prospective study.
Ultrasound Obstet Gynecol 2019; 53(3):402-409UO

Abstract

OBJECTIVES

The primary aim of this study was to compare the diagnostic accuracy of transvaginal sonography (TVS) with vs without bowel preparation (BP) in detecting the presence of rectosigmoid endometriosis. Secondary objectives were to compare the diagnostic accuracy of the two techniques in estimating infiltration of the submucosa, length of the largest rectosigmoid nodules, distance of the nodules from the anal verge and presence of multifocal disease.

METHODS

This was a prospective study of patients with symptoms of pelvic pain for more than 6 months and/or suspicion of endometriosis referred to our institution between October 2016 and April 2018. Participants underwent a first TVS without BP followed by TVS with BP within a time interval of 1 week to 3 months. The examinations were performed independently and blindly by two sonographers. Only patients who underwent laparoscopy within the 6 months following the second ultrasound examination were included. Ultrasound results using the two techniques were compared with surgical and histological findings.

RESULTS

Of the 262 patients included in the study, 118 had rectosigmoid endometriosis confirmed at surgery. There was no significant difference in accuracy between TVS with and that without BP in diagnosing the presence of rectosigmoid endometriosis (93.5% vs 92.3%; P = 0.453). No significant difference was observed in accuracy between TVS with and that without BP in diagnosing submucosal infiltration (88.8% vs 84.6%; P = 0.238) and multifocal disease (97.2% vs 95.2%; P = 0.727) in patients diagnosed sonographically with rectosigmoid endometriosis. The accuracy of TVS with BP was similar to that of TVS without BP in estimating the maximum diameter of the largest nodule (P = 0.644) and the distance between the more caudal rectosigmoid nodule and the anal verge (P = 0.162).

CONCLUSION

BP does not improve the diagnostic performance of TVS in detecting rectosigmoid endometriosis and in assessing characteristics of endometriotic nodules. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.

Authors+Show Affiliations

Academic Unit of Obstetrics and Gynecology, IRCCS AOU San Martino - IST, Genoa, Italy. Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy.Academic Unit of Obstetrics and Gynecology, IRCCS AOU San Martino - IST, Genoa, Italy. Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy.Department of Surgical and Diagnostic Sciences, IRCCS San Martino Hospital and National Institute for Cancer Research, University of Genoa, Genoa, Italy.Department of Surgical and Diagnostic Sciences, IRCCS San Martino Hospital and National Institute for Cancer Research, University of Genoa, Genoa, Italy.Academic Unit of Obstetrics and Gynecology, IRCCS AOU San Martino - IST, Genoa, Italy. Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy.Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

30079504

Citation

Ferrero, S, et al. "Transvaginal Sonography With Vs Without Bowel Preparation in Diagnosis of Rectosigmoid Endometriosis: Prospective Study." Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology, vol. 53, no. 3, 2019, pp. 402-409.
Ferrero S, Scala C, Stabilini C, et al. Transvaginal sonography with vs without bowel preparation in diagnosis of rectosigmoid endometriosis: prospective study. Ultrasound Obstet Gynecol. 2019;53(3):402-409.
Ferrero, S., Scala, C., Stabilini, C., Vellone, V. G., Barra, F., & Leone Roberti Maggiore, U. (2019). Transvaginal sonography with vs without bowel preparation in diagnosis of rectosigmoid endometriosis: prospective study. Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology, 53(3), pp. 402-409. doi:10.1002/uog.19194.
Ferrero S, et al. Transvaginal Sonography With Vs Without Bowel Preparation in Diagnosis of Rectosigmoid Endometriosis: Prospective Study. Ultrasound Obstet Gynecol. 2019;53(3):402-409. PubMed PMID: 30079504.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Transvaginal sonography with vs without bowel preparation in diagnosis of rectosigmoid endometriosis: prospective study. AU - Ferrero,S, AU - Scala,C, AU - Stabilini,C, AU - Vellone,V G, AU - Barra,F, AU - Leone Roberti Maggiore,U, Y1 - 2019/02/06/ PY - 2018/05/08/received PY - 2018/07/22/revised PY - 2018/07/23/accepted PY - 2018/8/7/pubmed PY - 2018/8/7/medline PY - 2018/8/7/entrez KW - bowel endometriosis KW - bowel preparation KW - diagnosis KW - endometriosis KW - transvaginal sonography SP - 402 EP - 409 JF - Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology JO - Ultrasound Obstet Gynecol VL - 53 IS - 3 N2 - OBJECTIVES: The primary aim of this study was to compare the diagnostic accuracy of transvaginal sonography (TVS) with vs without bowel preparation (BP) in detecting the presence of rectosigmoid endometriosis. Secondary objectives were to compare the diagnostic accuracy of the two techniques in estimating infiltration of the submucosa, length of the largest rectosigmoid nodules, distance of the nodules from the anal verge and presence of multifocal disease. METHODS: This was a prospective study of patients with symptoms of pelvic pain for more than 6 months and/or suspicion of endometriosis referred to our institution between October 2016 and April 2018. Participants underwent a first TVS without BP followed by TVS with BP within a time interval of 1 week to 3 months. The examinations were performed independently and blindly by two sonographers. Only patients who underwent laparoscopy within the 6 months following the second ultrasound examination were included. Ultrasound results using the two techniques were compared with surgical and histological findings. RESULTS: Of the 262 patients included in the study, 118 had rectosigmoid endometriosis confirmed at surgery. There was no significant difference in accuracy between TVS with and that without BP in diagnosing the presence of rectosigmoid endometriosis (93.5% vs 92.3%; P = 0.453). No significant difference was observed in accuracy between TVS with and that without BP in diagnosing submucosal infiltration (88.8% vs 84.6%; P = 0.238) and multifocal disease (97.2% vs 95.2%; P = 0.727) in patients diagnosed sonographically with rectosigmoid endometriosis. The accuracy of TVS with BP was similar to that of TVS without BP in estimating the maximum diameter of the largest nodule (P = 0.644) and the distance between the more caudal rectosigmoid nodule and the anal verge (P = 0.162). CONCLUSION: BP does not improve the diagnostic performance of TVS in detecting rectosigmoid endometriosis and in assessing characteristics of endometriotic nodules. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd. SN - 1469-0705 UR - https://www.unboundmedicine.com/medline/citation/30079504/Transvaginal_sonography_with_vs_without_bowel_preparation_in_diagnosis_of_rectosigmoid_endometriosis:_prospective_study_ L2 - https://doi.org/10.1002/uog.19194 DB - PRIME DP - Unbound Medicine ER -