Transvaginal ultrasonography with bowel preparation is able to predict the number of lesions and rectosigmoid layers affected in cases of deep endometriosis, defining surgical strategy

Gonçalves, Maynara Santana; Podgaec, Sérgio; Dias, João; Gonzalez, M. Mendo; Abrão, Maurício Simões

doi:10.1093/humrep/dep433

Cited by 166 publications

(143 citation statements)

References 32 publications

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“…Transvaginal ultrasound is the natural first choice of image modality when investigating pelvic pain and endometriosis (including deep lesions) [16,17]. MRI represents an accurate method for the detection of adenomyosis, sensitivity, and specificity varying from 86 % to 100 % [5,14,[18][19][20][21][22], making this a highly effective tool for the diagnosis of this disease [14].…”

Section: Introductionmentioning

confidence: 99%

Patients with adenomyosis are more likely to have deep endometriosis

et al. 2012

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This study seeks to analyze the association between adenomyosis diagnosed by magnetic resonance imaging (MRI) and endometriosis. This is a prospective study of consecutive patients. One hundred fifty-two patients with histologically confirmed endometriosis. Patients were submitted to MRI, then divided into Group A (with adenomyosis) and Group B (without adenomyosis). Thickness of the junctional zone and the presence of intramyometrial cysts were the principal criteria for diagnosis of adenomyosis. MRI data were correlated with clinical status, staging, sites affected, and histological classification of endometriosis. The prevalence of adenomyosis in endometriosis patients was 42.76 %. Patients with endometriosis and adenomyosis were more likely than those without adenomyosis to report severe or incapacitating dysmenorrhea (61.53 % in Group A; 44.83 % in Group B; p00.041) and deep dyspareunia (64.61 % in Group A; 41.38 % in Group B; p00.005), to have stage IV endometriosis (50.77 % in Group A; 33.34 % in Group B; p00.03), to have endometriosis of the rectosigmoid (49.23 % in Group A; 32.18 % in Group B; p00.033), and to have undifferentiated or mixed histological types of endometriosis (52.31 % in Group A; 34.48 % in Group B; p00.028). A correlation was found between adenomyosis and deep endometriosis with poorer prognosis, particularly endometriosis of the rectosigmoid.

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Section: Introductionmentioning

confidence: 99%

Patients with adenomyosis are more likely to have deep endometriosis

et al. 2012

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“…Apesar de o diagnóstico padrão-ouro da endometriose em mulheres com dor pélvica crônica ser a inspeção visual da pelve realizada por laparotomia ou, preferencialmente, por laparoscopia 4 , vários autores têm demonstrado a possibilidade de se mapear a doença no pré-operatório utilizando exames de imagem, notadamente nos casos de endometriose profunda infiltrativa (EPI) e de endometriomas ovarianos [5][6][7][8] .…”

Section: Introductionunclassified

Associação entre endometrioma ovariano e endometriose profunda infiltrativa

Kondo¹,

Ribeiro²,

Trippia³

et al. 2012

Rev. Bras. Ginecol. Obstet.

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ResumoOBJETIVO: Avaliar a associação do endometrioma ovariano e a presença de lesões de endometriose profunda infiltrativa (EPI) em uma amostra de mulheres do Sul do Brasil. MÉTODOS: Foi conduzida uma análise retrospectiva com informações dos prontuários de mulheres submetidas a tratamento cirúrgico de endometriose durante o período de janeiro de 2010 e junho de 2012. As pacientes foram divididas em dois grupos de acordo com a presença ou não de endometrioma ovariano. As pacientes portadoras de endometrioma ovariano foram subdivididas em dois grupos de acordo com o diâmetro do endometrioma (<40 e ≥40 mm). Os parâmetros comparados entre os grupos incluíram: dosagem sérica de cancer antigen (CA) 125, tamanho do endometrioma, presença e número de lesões profundas. A análise estatística foi conduzida com o programa Statistica versão 8.0, utilizando-se o teste exato de Fisher, o teste t de Student e o teste de Mann-Whitney, quando necessário. Os valores p<0,05 foram considerados estatisticamente significativos. RESULTADOS: Durante o período de estudo, um total de 201 mulheres foram submetidas a tratamento cirúrgico laparoscópico de endometriose. Cinquenta e seis pacientes (27,9%) eram portadoras de endometrioma ovariano e 180 pacientes (89,5%) apresentaram EPI confirmada histologicamente. As mulheres com endometrioma ovariano apresentaram um CA 125 sérico mais alto (39,5 versus 24,1 U/mL; p<0,01) e uma maior associação com a presença de lesões de EPI (98,2 versus 86,2%; p=0,01) e de EPI intestinal (57,1 versus 37,9%; p=0,01). Não houve diferença significativa quando se comparou os grupos com endometriomas <40 e ≥40 mm. CONCLUSÕES: O endometrioma ovariano é um marcador para a presença de lesões de EPI, incluindo EPI com comprometimento intestinal. Abstract PURPOSE:To evaluate the association between ovarian endometrioma and the presence of deep infiltrating endometriosis (DIE) lesions in a sample of women of the South of Brazil. METHODS: A retrospective study was conducted in all women undergoing surgical treatment of endometriosis from January 2010 to June 2012. Patients were divided into 2 groups according to the presence or not of ovarian endometrioma. Patients presenting an ovarian endometrioma were subsequently divided into 2 groups according to the diameter of the endometrioma (<40 and ≥40 mm). The following parameters were compared between the groups: cancer antigen (CA) 125 level, size of the endometrioma, presence and number of deep lesions. The statistical analysis was performed with Statistica version 8.0 using Fisher's exact test, Student's t-test and Mann-Whitney test, when needed. The p values of <0.05 were considered statistically significant. RESULTS: During the study period, a total of 201 women underwent laparoscopic surgical treatment of endometriosis. Fifty-five patients (27.9%) presented ovarian endometrioma and 180 patients (89.5%) presented DIE confirmed by pathologic examination. Women presenting an ovarian endometrioma had higher CA 125 levels (39.5 versus 24.1 U/mL; p<0.01) and stronger assoc...

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“…Thus, timely and proper surgical management of endometrioma and excision of its dependent peritoneal site could serve not only to manage patients' pain, but also to conceivably prevent a significant percentage of DIE. In one study focusing exclusively on patients with rectosigmoid lesions, 48% and 84% had ovarian endometriosis and retrocervical lesions, respectively [17] (Figure 3). Both superficial peritoneal and ovarian endometriomas may be found in association with DIE in variable percentages, thus contributing to the intensity of painful stimuli, as well as to infertility [18].…”

Section: Discussionmentioning

confidence: 99%

Identical Ovarian and Deep Pelvic Endometriosis with Colorectal Involvement in Monozygotic Twins: A Case Report and Review of the Literature

Miller¹

2017

BJSTR

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Transvaginal ultrasonography with bowel preparation is able to predict the number of lesions and rectosigmoid layers affected in cases of deep endometriosis, defining surgical strategy

Cited by 166 publications

References 32 publications

Patients with adenomyosis are more likely to have deep endometriosis

Patients with adenomyosis are more likely to have deep endometriosis

Associação entre endometrioma ovariano e endometriose profunda infiltrativa

Identical Ovarian and Deep Pelvic Endometriosis with Colorectal Involvement in Monozygotic Twins: A Case Report and Review of the Literature

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