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

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ROS, Cristina
RIUS, Mariona
MUNROS, Jordina
GRACIA, Meritxell
CARMONA, Francisco
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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.
Bowel endometriosis, Bowel preparation, Deep infiltrating endometriosis, Pelvic pain, Transvaginal ultrasound
  1. Ribeiro HSAA, 2008, J MINIM INVAS GYN, V15, P315, DOI 10.1016/j.jmig.2008.02.001
  2. Abrao MS, 2007, HUM REPROD, V22, P3092, DOI 10.1093/humrep/dem187
  3. Abrao MS, 2008, J MINIM INVAS GYN, V15, P280, DOI 10.1016/j.jmig.2008.01.006
  4. Abrao MS, 2015, HUM REPROD UPDATE, V21, P329, DOI 10.1093/humupd/dmv003
  5. Abrao MS, 2004, J AM ASSOC GYN LAP, V11, P50
  6. Bazot M, 2004, RADIOLOGY, V232, P379, DOI 10.1148/radiol.2322030762
  7. Bazot M, 2003, HUM REPROD, V18, P1686, DOI 10.1093/humrep/deg314
  8. Biscaldi E, 2007, EUR RADIOL, V17, P211, DOI 10.1007/s00330-006-0364-5
  9. Chamie LP, 2010, RADIOGRAPHICS, V30, P1235, DOI 10.1148/rg.305095221
  10. Chapron C, 2003, HUM REPROD, V18, P760, DOI 10.1093/humrep/deg152
  11. Chapron C, 1998, HUM REPROD, V13, P2266, DOI 10.1093/humrep/13.8.2266
  12. Chapron C, 2006, HUM REPROD, V21, P1839, DOI 10.1093/humrep/del079
  13. Coccia ME, 2011, ANN NY ACAD SCI, V1221, P61, DOI 10.1111/j.1749-6632.2011.05951.x
  14. Goncalves MOD, 2010, HUM REPROD, V25, P665, DOI 10.1093/humrep/dep433
  15. Dessole S, 2003, FERTIL STERIL, V79, P1023, DOI 10.1016/S0015-0282(02)04952-X
  16. Ferrero S, 2010, J ENDOMETR PELVIC PA, V2, P71
  17. Goncalves MO, 2009, INT J GYNECOL OBSTET, V104, P156, DOI 10.1016/j.ijgo.2008.10.005
  18. Griffiths AN, 2007, J OBSTET GYNAECOL, V27, P605, DOI 10.1080/01443610701497660
  19. Guerriero S, 2016, ULTRASOUND OBST GYN, V48, P318, DOI 10.1002/uog.15955
  20. Guerriero S, 2007, FERTIL STERIL, V88, P1293, DOI 10.1016/j.fertnstert.2006.12.060
  21. Hudelist G, 2011, ULTRASOUND OBST GYN, V37, P257, DOI 10.1002/uog.8858
  22. Koga K, 2003, HUM REPROD, V18, P1328, DOI 10.1093/humrep/deg243
  23. Leon M, 2014, J ULTRAS MED, V33, P315, DOI 10.7863/ultra.33.2.315
  24. Menada MV, 2008, HUM REPROD, V23, P1069, DOI 10.1093/humrep/den057
  25. Piketty M, 2009, HUM REPROD, V24, P602, DOI 10.1093/humrep/den405
  26. Remorgida B, 2005, HUM REPROD, V20, P264, DOI 10.1093/humrep/deh568
  27. Roman H, 2011, HUM REPROD, V26, P274, DOI 10.1093/humrep/deq332
  28. Vignali M, 2005, J MINIM INVAS GYN L, V12, P508, DOI 10.1016/j.jmig.2005.06.016