Rectal endoscopic ultrasound with a radial probe in the assessment of rectovaginal endometriosis

Abstract

Study objective: To evaluate the accuracy of rectal endoscopic ultrasound and to evaluate endometriosis in the rectovaginal septum, rectum, and sigmoid walls.

Design: Validation of diagnostic test (Canadian Task Force classification II-1).

Setting: Tertiary care hospital.

Patients: Thirty-two consecutive women clinically suspected of having rectovaginal septum endometriosis without previous surgical treatment.

Intervention: Colonoscopy, transrectal ultrasound, and rectal endoscopic ultrasound, followed by laparoscopy or laparotomy.

Measurements and main results: The disease was classified according to 1996 standards of the American Society of Reproductive Medicine. Images obtained by colonoscopy, endoscopic ultrasound, and surgery and histologic findings were compared. In 6 patients endometriosis infiltrated bowel muscularis wall, in 20 it infiltrated rectovaginal septum, and in the remaining 6 there was no evidence of lesions. In all women in whom infiltration of the intestinal wall was suspected, rectal endoscopic ultrasound and colonoscopy confirmed the lesions (sensitivity 100%, specificity 67%).

Conclusion: Endoscopic ultrasound was useful in preoperative assessment of women with endometriosis.