[Endorectal sonography in gynecology: usefulness and diagnostic accuracy]

The aim of this study was to assess feasibility and diagnostic accuracy of endorectal sonography (ERS) in comparison with transabdominal sonography (TAS) in women with a contraindication to endovaginal sonography (EVS).

ERS was proposed to 32 patients in the immediate continuation of TAS. It was performed either with a specific probe or with a vaginal probe. The protocol included a complete evaluation of pelvic structures observed with both sonographic techniques.

After counselling and assent, 29 of the 32 patients (90%) accepted ERS. The examination was regarded as complete in 28 cases. ERS confirmed the absence of pelvic anomaly in the 12 cases of normal TAS. ERS modified diagnosis in 5 of the 8 cases of anechoic ovarian cysts seen in TAS. In 4 cases, PCOs not seen in TAS were identified. Two partially sub-mucous myomas not recognized by TAS were diagnosed by ERS. Sensibility, specificity, positive predictive value (PPV) and negative predictive value (NPV) of TAS and ERS were 38,4 and 87,5%, 41,6 and 100%, 50 and 100%, 40 and 85,7% respectively.

These findings suggest ERS is an effective diagnostic tool in pelvic exploration when EVS cannot be performed. It should be widely proposed after information and assent.