Transvaginal Ultrasound Findings After Laparoscopic Rectosigmoid Segmental Resection for Deep Infiltrating
Francesco G Martire1, Errico Zupi2, Lucia Lazzeri2
1Department of Surgical Sciences, Gynecologic Unit, University of Rome Tor Vergata, Rome, Italy.
Summary
Postoperative transvaginal ultrasound (TVUS) can detect persistent deep infiltrating endometriosis (DIE) and adhesions after rectosigmoid resection, even in asymptomatic patients. Adenomyosis may also contribute to ongoing pelvic pain symptoms.
Area of Science:
- Gynecology
- Surgical Oncology
- Diagnostic Imaging
Background:
- Deep infiltrating endometriosis (DIE) significantly impacts women's quality of life.
- Segmental rectosigmoid resection is a surgical option for bowel endometriosis.
- Postoperative assessment is crucial for managing residual disease and symptoms.
Purpose of the Study:
- To evaluate transvaginal ultrasound (TVUS) findings after segmental rectosigmoid resection for DIE.
- To correlate these postsurgical TVUS findings with patient symptoms.
- To assess the prevalence of adhesions and disease recurrence.
Main Methods:
- Retrospective study of 50 premenopausal women post-rectosigmoid resection for DIE.
- TVUS performed within 12 months post-surgery.
- Assessment of symptoms including pain, dysmenorrhea, dyspareunia, dysuria, and dyschezia.
Main Results:
- High rate of adhesions (90%) detected by TVUS, associated with bowel symptoms.
- Negative sliding sign observed in 58% of patients, indicating adhesions.
- Recurrence of posterior DIE in 18% and endometriomas in 16%; adenomyosis found in 80%.
Conclusions:
- Symptomatic patients with DIE may persist after surgery.
- Postoperative TVUS is valuable for identifying residual disease, adhesions, and adenomyosis.
- Women should be informed about potential persistent symptoms and findings detectable by TVUS.
