Transvaginal ultrasonography combined with water-contrast in the rectum in the diagnosis of rectovaginal endometriosis infiltrating the bowel

Menada, Mario Valenzano; Remorgida, Valentino; Abbamonte, Luiza Helena; Fulcheri, Ezio; Ragni, Nicola; Ferrero, Simone

doi:10.1016/j.fertnstert.2007.07.1336

Cited by 55 publications

(38 citation statements)

References 4 publications

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“…The diagnosis of rectovaginal endometriosis was based on vaginal and rectal examinations and confirmed by rectal water contrast transvaginal ultrasonography [15-17]. Patients with gastrointestinal complains suggestive of bowel endometriosis underwent multidetector computerized tomography enteroclysis [18-20].…”

Section: Methodsmentioning

confidence: 99%

Letrozole and norethisterone acetate versus letrozole and triptorelin in the treatment of endometriosis related pain symptoms: a randomized controlled trial

Ferrero

Venturini

Gillott

et al. 2011

Reprod Biol Endocrinol

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BackgroundWhen aromatase inhibitors are used to treat premenopausal women with endometriosis, additional drugs should be used to effectively down-regulate gonadal estrogen biosynthesis. This randomized prospective open-label study compared the efficacy in treating pain symptoms and the tolerability of letrozole combined with either norethisterone acetate or triptorelin.MethodsWomen with pain symptoms caused by rectovaginal endometriosis were treated with letrozole (2.5 mg/day) and were randomized to also receive either oral norethisterone acetate (2.5 mg/day; group N) or intramuscular injection of triptorelin (11.25 mg every 3 months; group T). The scheduled length of treatment was 6 months. A visual analogue scale and a multidimensional categorical rating scale were used to assess the severity of pain symptoms. The volume of the endometriotic nodules was estimated by ultrasonography using virtual organ computer-aided analysis. Adverse effects of treatment were recorded.ResultsA total of 35 women were randomized between the two treatment protocols. Significantly more patients in group N rated their treatment as satisfactory or very satisfactory (64.7%) as compared to group T (22.2%; p = 0.028). The intensity of both non-menstrual pelvic pain and deep dyspareunia significantly decreased during treatment in both study groups, though no statistically meaningful difference between the two groups was apparent. Reduction in the volume of endometriotic nodules was significantly greater in group T than in group N. Interruption of treatment due to adverse effects significantly differed between the groups, with 8 women in group T (44.4%) and 1 woman in group N (5.9%) interrupting treatment (p = 0.018). Similarly, 14 women included in group T (77.8%) and 6 women included in group N (35.3%) experienced adverse effects of treatment (p = 0.018). During treatment, mineral bone density significantly decreased in group T but not in group N.ConclusionsAromatase inhibitors reduce the intensity of endometriosis-related pain symptoms. Combining letrozole with oral norethisterone acetate was associated with a lower incidence of adverse effects and a lower discontinuation rate than combining letrozole with triptorelin.

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Section: Methodsmentioning

confidence: 99%

Letrozole and norethisterone acetate versus letrozole and triptorelin in the treatment of endometriosis related pain symptoms: a randomized controlled trial

Ferrero

Venturini

Gillott

et al. 2011

Reprod Biol Endocrinol

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“…The most frequent is the involvement of the proximal medial portion of the uterosacral ligaments along the posterolateral margin of the cervix. Endometriosis of the uterosacral ligaments may directly extend to the rectum or to the lateral fornices [10, 34]. Some studies use the value of 9 mm for uterosacral ligament thickness to define involvement.…”

Section: Mri Techniquementioning

confidence: 99%

The Importance and Perspective of Magnetic Resonance Imaging in the Evaluation of Endometriosis

Bianek-Bodzak

Szurowska

Sawicki

et al. 2013

BioMed Research International

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MR imaging is becoming increasingly important in the assessment of patients with endometriosis. Its multiplanar capabilities and superior soft tissue contrast are particularly useful in the detection of deep infiltrating endometriotic implants. Endometriosis, defined as the presence of endometrial glands and stroma outside the endometrium, is among the most common gynaecological disorders affecting women in their reproductive age. The diagnosis and evaluation of the extension of endometriosis are difficult only with physical examination and laparoscopy. According to the authors' personal experience, a special MRI technique and some imaging guidelines regarding different anatomical localizations of endometriosis are discussed. This review is a brief presentation of current evidence on the diagnostic accuracy of MRI in the evaluation of endometriosis concerning other diagnostic methods, the limitations of MRI and its essential usefulness for preoperative diagnosis of deep pelvic endometriosis, and future perspectives in monitoring this disease.

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“…The imaging exams capable of providing these data are: transvaginal ultrasonography (Bazot et al, 2003, Abrao et al, 2007Menada et al, 2008;Guerriero et al, 2008), transrectal ultrasonography (Chapron et al, 1998;Koga et al, 2003), endoscopic transrectal ultrasonography (Bazot et al, 2003;Abrao et al, 2004), magnetic resonance imaging (Abrao et al, 2007, Bazot et al, 2008, multislice computed tomography (Biscaldi et al, 2007) and barium enema (Ribeiro et al, 2008). All these methods have been evaluated with respect to their applicability in defining the above-mentioned questions.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2009

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background: Successful surgical treatment of deep bowel endometriosis depends on obtaining detailed information about the lesions, prior to the procedure. The objective of this study was to determine the capability of transvaginal ultrasonography with bowel preparation (TVUS-BP) to predict the presence of one or more rectosigmoid nodules and the deepest bowel layer affected by the disease. results: With respect to bowel nodule detection and presence of at least two rectosigmoid lesions, TVUS-BP had a sensitivity of 97 and 81%, specificity 100 and 99%, positive predictive value (PPV) 100 and 93% and negative predictive value (NPV) 98 and 96%, respectively. Regarding diagnosis of infiltration of the submucosal/mucosal layer, TVUS-BP had a sensitivity of 83%, specificity 94%, PPV 77%, NPV 96%.conclusions: These findings show that TVUS-BP is an adequate exam for evaluating the presence of one or more rectosigmoid nodules and the deepest layer affected in deep infiltrating bowel endometriosis, confirming the importance of this technique for defining the most appropriate surgical strategy to be implemented.

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Transvaginal ultrasonography combined with water-contrast in the rectum in the diagnosis of rectovaginal endometriosis infiltrating the bowel

Cited by 55 publications

References 4 publications

Letrozole and norethisterone acetate versus letrozole and triptorelin in the treatment of endometriosis related pain symptoms: a randomized controlled trial

Letrozole and norethisterone acetate versus letrozole and triptorelin in the treatment of endometriosis related pain symptoms: a randomized controlled trial

The Importance and Perspective of Magnetic Resonance Imaging in the Evaluation of Endometriosis

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

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