Rectovaginal endometriosis: head to head comparison between sonovaginography and magnetic resonance imaging

Abstract

Rectovaginal endometriosis: head to head comparison between sonovaginography and magnetic resonance imaging A. Vitagliano1, A. Andrisani1, F. Dessole2, G. Virdis2, R. Cappadona3, L. Marin1, G. Capobianco2, S. Dessole2, G. Ambrosini1 1Department of Women and Children’s Health, Unit of Gynecology and Obstetrics, University of Padua, Padua 2Gynecologic and Obstetric Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari 3University of Ferrara, Ferrara (Italy) Summary Background: Rectovaginal endometriosis (RVE) is a severe form of deep pelvic endometriosis associated with dysmenorrhoea, pelvic pain, and dyspareunia. Diagnosis of RVE is a challenge for clinicians. Aim of outhe present study was to compare the diagnostic accuracy of sonovaginography with MRI on a consecutive cohort of women referred to this institution due to RVE suspect. Materials and Methods: The authors performed a retrospective study on consecutive patients undergoing surgery at this Unit due to a suspicion of RVE. All women were subject to MRI and sonovaginography. Primary endpoint was to compare the diagnostic accuracy of sonovaginography and MRI in the detection of RVE. Results: RVE was diagnosed (with surgery plus histology) in 60 women. In all cases, the surgical procedure was completed without complications. Sonovaginography and MRI showed high sensitivity (95% vs. 81.7%) and similar specificity (93.8% and 91.2%, respectively) in the diagnosis of RVE. Conclusions: Sonovaginography, when performed by an expert sonographer, may represent a valid alternative to MRI for the diagnosis of RVE, with lower costs and minimal time consumption. Key words: Rectovaginal endometriosis (RVE); Deep pelvic endometriosis; Sonovaginography