OBJECTIVE: To critically analyze the diagnostic value of transvaginal sonography (TVS) for non-invasive, presurgical detection of bowel endometriosis. METHODS: MEDLINE (1966-2010) and EMBASE (1980-2010) databases were searched for relevant studies investigating the diagnostic accuracy of TVS for diagnosing deep infiltrating endometriosis involving the bowel. Diagnosis was established by laparoscopy and/or histopathological analysis. Likelihood ratios (LRs) were recalculated in addition to traditional measures of effectiveness. RESULTS: Out of 188 papers, a total of 10 studies fulfilled predefined inclusion criteria involving 1106 patients with suspected endometriosis. The prevalence of bowel endometriosis varied from 24 to 73.3%. LR+ ranged from 4.8 to 48.56 and LR- ranged from 0.02 to 0.36, with wide confidence intervals. Pooled estimates of sensitivities and specificities were 91 and 98%; LR+ and LR- were 30.36 and 0.09; and positive and negative predictive values were 98 and 95%, respectively. Three of the studies used bowel preparations to enhance the visibility of the rectal wall; one study directly compared the use of water contrast vs. no prior bowel enema, for which the LR- was 0.04 and 0.47, respectively. CONCLUSIONS: TVS with or without the use of prior bowel preparation is an accurate test for non-invasive, presurgical detection of deep infiltrating endometriosis of the rectosigmoid.
OBJECTIVE: To critically analyze the diagnostic value of transvaginal sonography (TVS) for non-invasive, presurgical detection of bowel endometriosis. METHODS: MEDLINE (1966-2010) and EMBASE (1980-2010) databases were searched for relevant studies investigating the diagnostic accuracy of TVS for diagnosing deep infiltrating endometriosis involving the bowel. Diagnosis was established by laparoscopy and/or histopathological analysis. Likelihood ratios (LRs) were recalculated in addition to traditional measures of effectiveness. RESULTS: Out of 188 papers, a total of 10 studies fulfilled predefined inclusion criteria involving 1106 patients with suspected endometriosis. The prevalence of bowel endometriosis varied from 24 to 73.3%. LR+ ranged from 4.8 to 48.56 and LR- ranged from 0.02 to 0.36, with wide confidence intervals. Pooled estimates of sensitivities and specificities were 91 and 98%; LR+ and LR- were 30.36 and 0.09; and positive and negative predictive values were 98 and 95%, respectively. Three of the studies used bowel preparations to enhance the visibility of the rectal wall; one study directly compared the use of water contrast vs. no prior bowel enema, for which the LR- was 0.04 and 0.47, respectively. CONCLUSIONS: TVS with or without the use of prior bowel preparation is an accurate test for non-invasive, presurgical detection of deep infiltrating endometriosis of the rectosigmoid.
Authors: U Ulrich; O Buchweitz; R Greb; J Keckstein; I von Leffern; P Oppelt; S P Renner; M Sillem; W Stummvoll; R-L De Wilde; K-W Schweppe Journal: Geburtshilfe Frauenheilkd Date: 2014-12 Impact factor: 2.915
Authors: U Ulrich; O Buchweitz; R Greb; J Keckstein; I von Leffern; P Oppelt; S P Renner; M Sillem; W Stummvoll; K-W Schweppe Journal: Geburtshilfe Frauenheilkd Date: 2013-09 Impact factor: 2.915
Authors: Albert M Wolthuis; Christel Meuleman; Carla Tomassetti; Thomas D'Hooghe; Anthony de Buck van Overstraeten; André D'Hoore Journal: World J Gastroenterol Date: 2014-11-14 Impact factor: 5.742
Authors: Peter A W Rogers; G David Adamson; Moamar Al-Jefout; Christian M Becker; Thomas M D'Hooghe; Gerard A J Dunselman; Asgerally Fazleabas; Linda C Giudice; Andrew W Horne; M Louise Hull; Lone Hummelshoj; Stacey A Missmer; Grant W Montgomery; Pamela Stratton; Robert N Taylor; Luk Rombauts; Philippa T Saunders; Katy Vincent; Krina T Zondervan Journal: Reprod Sci Date: 2016-09-27 Impact factor: 3.060
Authors: Vicki Nisenblat; Lucy Prentice; Patrick M M Bossuyt; Cindy Farquhar; M Louise Hull; Neil Johnson Journal: Cochrane Database Syst Rev Date: 2016-07-13