Combined Transvaginal/Transabdominal Pelvic Ultrasonography Accurately Predicts the 3 Dimensions of Deep Infiltrating Bowel Endometriosis Measured after Surgery: A Prospective Study in a Specialized Center

Giovanni, A. Di; Casarella, Lucia; Coppola, Marina; Iuzzolino, Domenico; Rasile, Marianna; Malzoni, Mario

doi:10.1016/j.jmig.2018.03.003

Cited by 18 publications

(31 citation statements)

References 29 publications

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“…In the current study, TVS was used to estimate the distance between the lower margin of the more caudal nodule and the anal verge. The consensus of the IDEA group, reviews by experts and clinical studies support the use of TVS in measuring this distance. However, while this measurement can easily be performed in the case of rectal nodules, it may be less precise when the endometriotic nodules are located on the rectosigmoid junction or on the sigmoid.…”

Section: Discussionmentioning

confidence: 96%

“…The distance between the lower margin of the more caudal nodule and the anal verge was estimated. The distance was evaluated by retracting the probe down to the perineal plane as previously described; straight or curved lines with calipers were used to trace the anterior rectosigmoid muscular layer as far as the anal verge. In cases of lower or upper rectal nodule, the distance was estimated using a single ultrasound image.…”

Section: Methodsmentioning

confidence: 99%

“…In cases of nodules not so low as to be included in a single screenshot (i.e. rectosigmoid and sigmoid nodules), estimation of the distance was performed using a split screen. The presence of multifocal disease (defined as the presence of additional nodules that affected the rectosigmoid) was assessed.…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Transvaginal sonography with vs without bowel preparation in diagnosis of rectosigmoid endometriosis: prospective study

Ferrero

Scala

Stabilini

et al. 2019

Ultrasound in Obstet & Gyne

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Section: Discussionmentioning

confidence: 96%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Transvaginal sonography with vs without bowel preparation in diagnosis of rectosigmoid endometriosis: prospective study

Ferrero

Scala

Stabilini

et al. 2019

Ultrasound in Obstet & Gyne

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show abstract

“…[93][94][95] It is also important to estimate the size of the lesion to determine the suitable surgical method to use, such as shaving, discoid excision, or segmental resection for bowel endometriosis. [96][97][98] This information can be gained presurgically with TVS 83,96,99 and is of pivotal importance in the presurgical planning and counseling of women. In addition, the learning curve for identifying rectosigmoid DE is rather steep.…”

Section: Rectosigmoidmentioning

confidence: 99%

Transvaginal Sonographic Imaging and Associated Techniques for Diagnosis of Ovarian, Deep Endometriosis, and Adenomyosis: A Comprehensive Review

et al. 2020

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Imaging of endometriosis and in particular deep endometriosis (DE) is crucial in the clinical management of women facing this debilitating condition. Transvaginal sonography (TVS) is the first-line imaging method and magnetic resonance imaging (MRI) may provide supplemental information. However, the delay in diagnosis of up to 10 years and more is of concern. This problem might be overcome by simple steps using imaging with emphasis on TVS and referral to tertiary care. Finally, TVS is crucial in mapping extent and location of disease in planning surgical therapy and counseling women regarding various therapeutic options. This review presents the available data on imaging of endometriosis with a focus on TVS and MRI for DE, adenomyosis, and ovarian endometriomas including endometriomas in pregnancy as well as the use of “soft markers.” The review presents an approach that is in accordance with the International Deep Endometriosis Analysis (IDEA) group consensus statement.

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“…Rectosigmoid DE exhibits typical sonographic features on TVS caused by infiltration of the muscularis propria 11 . Furthermore, recent evidence suggests that TVS can also be used to predict accurately the three dimensions of rectosigmoid DE lesions measured after surgical resection 12 .…”

Section: Introductionmentioning

confidence: 99%

Transvaginal sonography accurately measures lesion‐to‐anal‐verge distance in women with deep endometriosis of the rectosigmoid

Aas-Eng

Dauser

Lieng

et al. 2020

Ultrasound in Obstet & Gyne

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Objectives First, to investigate the accuracy of transvaginal sonography (TVS) for presurgical evaluation of the distance between the most caudal part of the endometriotic lesion and the anal verge (lesion‐to‐anal‐verge distance (LAVD)) in women with rectosigmoid deep endometriosis (DE), compared with intraoperative measurement (IOM). Second, to assess the agreement between anastomosis height and LAVD measured using TVS. Methods This was a prospective observational multicenter study of symptomatic women who were scheduled for surgical treatment of rectosigmoid DE, by either discoid or segmental resection, between April 2017 and September 2019. Presurgical TVS was performed to evaluate the LAVD in two ways, depending on the level of the lesion. Method 1: for lesions at the level of the rectovaginal septum (RVS), the caudal part of the lesion was identified on TVS and an index finger was placed on the TVS probe at the level of the anal verge. The probe was withdrawn and the distance from the tip of the TVS probe down to the index finger was measured using a ruler, representing the LAVD. Method 2: for lesions above the RVS, the distance between the caudal part of the lesion and the lower lip of the posterior cervix was measured in a frozen image (LAVD‐1), and the distance between the lower lip of the posterior cervix and the anal verge (LAVD‐2) was measured using Method 1. These two measurements (LAVD‐1 and LAVD‐2) were added together and the result represented the total LAVD. During surgery, a rectal probe was used to perform IOM of LAVD, which was considered as the gold standard test. Agreement between LAVD measured using TVS and the IOM was assessed using Bland–Altman analysis. The intraclass correlation coefficient (ICC) for absolute agreement and Spearman's correlation coefficient were also calculated. Systematic and proportional bias were tested for significance using the paired t‐test. Similar analysis was performed to assess agreement between LAVD measured using TVS and anastomosis height. Results A total of 147 consecutive women were considered eligible for inclusion. Fourteen women were excluded initially. Thirty‐four discoid resections and 102 segmental resections were performed; both procedures were performed in three women. Two more women were excluded from the final analysis because the measurements represented extreme outliers. The mean LAVD measured using TVS was 114.8 ± 36.5 mm and the mean IOM was 116.9 ± 42.3 mm. There was no statistically significant difference between LAVD measured using TVS and IOM (mean difference, –2.12 mm (95% CI, –6.33 to 2.05 mm); P = 0.32). Bland–Altman analysis showed that there was good agreement between the two methods. The ICC was 0.81 (95% CI, 0.74–0.86) and Spearman's correlation coefficient was 0.68 (95% CI, 0.56–0.77). The mean difference between LAVD measured using TVS and anastomosis height was statistically, but not clinically, significant (mean difference, 10.25 mm (95% CI, 5.94–14.32 mm); P = 0.0005), and the ICC was 0.78 (95% CI, 0.66–0.85). Conclus...

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Combined Transvaginal/Transabdominal Pelvic Ultrasonography Accurately Predicts the 3 Dimensions of Deep Infiltrating Bowel Endometriosis Measured after Surgery: A Prospective Study in a Specialized Center

Abstract: We believe that US can be considered an accurate diagnostic technique for the evaluation of deep infiltrating bowel endometriosis when performed by a dedicated experienced sonographer in a specialized center.

Cited by 18 publications

References 29 publications

Transvaginal sonography with vs without bowel preparation in diagnosis of rectosigmoid endometriosis: prospective study

Transvaginal sonography with vs without bowel preparation in diagnosis of rectosigmoid endometriosis: prospective study

Transvaginal Sonographic Imaging and Associated Techniques for Diagnosis of Ovarian, Deep Endometriosis, and Adenomyosis: A Comprehensive Review

Transvaginal sonography accurately measures lesion‐to‐anal‐verge distance in women with deep endometriosis of the rectosigmoid

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