scholarly journals OC20.06: Comparison of diagnostic accuracy of transvaginal ultrasound for deep endometriosis and pouch of Douglas obliteration in the presence and absence of ovarian endometriomas

2019 ◽  
Vol 54 (S1) ◽  
pp. 52-52
Author(s):  
M. Leonardi ◽  
C. Lu ◽  
S. Reid ◽  
K. Vanza ◽  
M. Espada ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Transvaginal Ultrasound ◽  
Deep Endometriosis ◽  
Pouch Of Douglas ◽  
Presence And Absence ◽  
Ovarian Endometriomas

scholarly journals A Case of Elastography-Assisted Laparoscopic Fertility Preservation for Severe Deep Endometriosis Causing Ureteral Stenosis and Subtype II Adenomyosis

Endocrines ◽  
2021 ◽  
Vol 2 (3) ◽  
pp. 348-355
Author(s):  
Yoshiaki Ota ◽  
Kuniaki Ota ◽  
Toshifumi Takahashi ◽  
Yumiko Morimoto ◽  
So-Ichiro Suzuki ◽  
...  
Keyword(s):  
Transvaginal Ultrasound ◽  
Complete Removal ◽  
Posterior Wall ◽  
Complete Resection ◽  
Reproductive Age ◽  
High Recurrence Rate ◽  
Ureteral Stenosis ◽  
Deep Endometriosis ◽  
Pouch Of Douglas ◽  
Residual Lesions

Adenomyosis is commonly treated by total hysterectomy. Adenomyomectomy is considered for women of reproductive age who wish to preserve their fertility. However, a high recurrence rate following adenomyomectomy has been reported because complete removal of the lesion is difficult, and uterine rupture during pregnancy remains a complication. We previously reported that laparoscopic adenomyomectomy using a cold knife prevented thermal damage to the myometrium and elastography to avoid residual lesions. Here, we report the case of a patient who underwent complete resection of a subtype II adenomyosis and resection of deep endometriosis (DE) with the closure of the pouch of Douglas. The patient was 31 years old, had severe dysmenorrhea, and had left ureteral stenosis and subtype II adenomyosis associated with the closure of the pouch of Douglas by the DE. After resection of the DE posterior wall adenomyosis, residual lesions were confirmed by laparoscopic real-time elastography. Eight weeks after surgery, postoperative transvaginal ultrasound showed that the myometrium had shrunk from 28 to 22.7 mm, and the hydronephrosis had disappeared, although a stent remained necessary. In this study, we report the complete resection of subtype II adenomyosis and DE, combined with elastography to visualize the lesions during resection.

Ultrasonographic 3D Evaluation in the Diagnosis of Bladder Endometriosis: A Prospective Comparative Diagnostic Accuracy Study

2021 ◽  
pp. 1-8
Author(s):  
Fabio Barra ◽  
Franco Alessandri ◽  
Carolina Scala ◽  
Simone Ferrero
Keyword(s):  
Diagnostic Accuracy ◽  
Three Dimensional ◽  
3D Ultrasound ◽  
Diagnostic Accuracy Study ◽  
Extensive Experience ◽  
Deep Endometriosis ◽  
3D Reconstructions ◽  
Analysis Group ◽  
Bladder Endometriosis ◽  
Accuracy Study

<b><i>Objective:</i></b> The use of three-dimensional (3D) transvaginal ultrasonography (TVS) has been investigated for the diagnosis of deep endometriosis (DE). This study aimed to evaluate if 3D reconstructions improve the performance of TVS) in assessing the presence and characteristics of bladder endometriosis (BE). <b><i>Design:</i></b> This was a single-center comparative diagnostic accuracy study. <b><i>Participants/Materials, Setting, Methods:</i></b> Patients referred to our institution (Piazza della Vittoria 14 Srl, Genova, Italy) with clinical suspicion of DE were included. In case of surgery, women underwent systematic preoperative ultrasonographic imaging; an experienced sonographer performed a conventional TVS; another experienced sonographer, blinded to results of the previous exam, performed TVS, with the addition of 3D modality. The presence and characteristics of BE nodules were described in accord with International DE Analysis group consensus. Ultrasound data were compared with surgical and histological results. <b><i>Results:</i></b> Overall, BE was intraoperatively found in 34 out of 194 women who underwent surgery for DE (17.5%; 95% confidence interval: 12.8–23.5%). TVS without and with 3D reconstructions were able to detect endometriotic BE in 82.2% (<i>n</i> = 28/34) and 85.3% (<i>n</i> = 29/34) of the cases (<i>p</i> = 0.125). Both the exams similarly estimated the largest diameter of BE (<i>p</i> = 0.652) and the distance between the endometriotic nodule and the closest ureteral meatus (<i>p</i> = 0.341). However, TVS with 3D reconstructions was more precise in estimating the volume of BE (<i>p</i> = 0.031). In one case (2.9%), TVS without and with 3D reconstructions detected the infiltration of the intramural ureter, which was confirmed at surgery and required laparoscopic ureterovesical reimplantation. <b><i>Limitations:</i></b> The extensive experience of the gynecologists performing the ultrasonographic scans, the lack of prestudy power analysis, and the population selected, which may have been influenced by the position of the institution as a referral center specialized in the treatment of severe endometriosis, are limitations of the current study. <b><i>Conclusion:</i></b> Our results demonstrated the high accuracy of ultrasound for diagnosing BE. The addition of 3D reconstructions does not improve the performance of TVS in diagnosing the presence and characteristics of BE. However, the volume of BE may be more precisely assessed by 3D ultrasound.

Laparoscopic findings after transvaginal ultrasound-guided aspiration of ovarian endometriomas

1995 ◽  
Vol 10 (11) ◽  
pp. 2902-2903 ◽  
Author(s):  
L. Muzii ◽  
R. Marana ◽  
P. Caruana ◽  
G.F. Catalano ◽  
S. Mancuso
Keyword(s):  
Transvaginal Ultrasound ◽  
Ultrasound Guided ◽  
Ovarian Endometriomas

Learning curve for the detection of pouch of Douglas obliteration and deep endometriosis of the rectum in gynaecological sonology trainees

2019 ◽  
Vol 45 ◽  
pp. S105-S106
Author(s):  
Mathew Leonardi ◽  
Ekavi Georgousopoulou ◽  
Mercedes Espada ◽  
Nicole Stamatopoulos ◽  
Sally Lord ◽  
...  
Keyword(s):  
Learning Curve ◽  
Deep Endometriosis ◽  
Pouch Of Douglas
Sign in / Sign up

Export Citation Format

Share Document