Bowel Preparation Improves the Accuracy of Transvaginal Ultrasound in the Diagnosis of Rectosigmoid Deep Infiltrating Endometriosis: A Prospective Study

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Citações na Scopus
28
Tipo de produção
article
Data de publicação
2017
Título da Revista
ISSN da Revista
Título do Volume
Editora
ELSEVIER SCIENCE INC
Autores
ROS, Cristina
MARTINEZ-SERRANO, Maria Jose
RIUS, Mariona
MUNROS, Jordina
MARTINEZ-ZAMORA, Ma Angeles
GRACIA, Meritxell
CARMONA, Francisco
Citação
JOURNAL OF MINIMALLY INVASIVE GYNECOLOGY, v.24, n.7, p.1146-1152, 2017
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Study Objective: To compare the accuracy of transvaginal ultrasound (TVUS) with and without bowel preparation (BP) to detect and describe intestinal nodules of deep infiltrating endometriosis (DIE) with laparoscopic findings. Design: A prospective study of paired data (Canadian Task Force classification II.1). Setting: A tertiary university hospital from November 2014 to November 2015. Patients: A cohort of women awaiting surgery for endometriosis. Interventions: The wall of the rectum and the lower sigmoid colon of the patients were evaluated by 2 TVUSs: the first ultrasound was performed without previous BP, and the second was done after a 3-day low-residue diet and two 250-mL enemas 12 hours and 3 hours before TVUS. Measurements and Main Results: The presence or absence of rectosigmoid nodules visualized by TVUS with and without BP was compared with laparoscopic results. Forty patients with a mean age of 36.8 +/- 5.0 years were included in the study. By comparing the surgical findings histologically confirmed (the presence or absence of bowel nodules and localization) with those of the 2 TVUSs with and without BP, the sensitivity, specificity, and Cohen kappa were 100%, 96%, and 0.95 and 73%, 88%, and 0.61, respectively. Laparoscopy showed that up to 37.5% of patients (15/40) presented bowel involvement. Variables were clearly more evaluable with than without BR. Conclusion: TVUS with BP has a higher accuracy than TVUS without BR. BP allows and facilitates the detection of more rectal nodules of DIE in patients with suspected endometriosis and surgical criteria.
Palavras-chave
Bowel endometriosis, Bowel preparation, Deep infiltrating endometriosis, Pelvic pain, Transvaginal ultrasound
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