scholarly journals Transvaginal ultrasound (USTV) for Deep Pelvic Endometriosis: How “To Do” do it

2019 ◽  
Vol 45 ◽  
pp. S100-S101
Author(s):  
Maria Cristina Chammas ◽  
Ana Paula Klautau Leite ◽  
Sandra Monica Tochetto ◽  
Julia Diva Zavariz
2019 ◽  
Vol 52 (5) ◽  
pp. 337-341 ◽  
Author(s):  
Jorge Gilmar Amaral de Oliveira ◽  
Vanessa Bonfada ◽  
Janice de Fátima Pavan Zanella ◽  
Janaina Coser

Abstract Endometriosis is characterized by the presence of endometrial tissue outside the uterus. When endometrial implants penetrate more than 5 mm into the peritoneum, the condition is referred to as deep pelvic endometriosis. Although laparoscopy is the gold standard test to establish a diagnosis of deep endometriosis, transvaginal ultrasound represents an alternative that can contribute to detection of the disease, because it is an accessible, low-cost, noninvasive examination that allows preoperative planning in cases requiring surgical treatment. However, in clinical practice, transvaginal ultrasound is still not widely used as the first-line examination in suspected cases of endometriosis. This essay describes the findings of deep endometriosis on transvaginal ultrasound, in order to disseminate knowledge of the utility of the technique for the diagnosis of this disease.


2009 ◽  
Vol 1 (3-4) ◽  
pp. 150-156 ◽  
Author(s):  
Carlo Saccardi ◽  
Andrea Cocco ◽  
Alberto Tregnaghi ◽  
Erich Cosmi ◽  
Nicola Baldan ◽  
...  

Purpose to determine the efficacy of laparoscopic excision of deep pelvic endometriosis (DPE). Methods One hundred and two highly symptomatic women with DPE underwent clinical examination, transvaginal ultrasound, nuclear magnetic resonance (NMR) and sonovaginography. Among the 102 women, 50 patients, with severe symptoms, underwent laparoscopic excision of DPE. Endoscopic surgery was performed with complete separation of the rectovaginal space and resection of the node. In the case of vaginal involvement vaginal exeresis was performed, in the case of rectal wall involvement of more than 50%, segmental bowel resection was performed. Operative data as well as dysmenorrhea, dyspareunia, chronic pelvic pain and dyschezia before and 6 and 12 months after surgical treatment were recorded. Results Mean operative time was 126.4 ± 34.7 min, mean blood loss was 76.2 ± 22 ml. In 17 (34%) cases we performed excision of the posterior vaginal fornix due to vaginal wall involvement. In six (12%) cases we performed excision of the rectal wall. At 12-month follow-up 39 (78%) women revealed absent or mild dysmenorrhea, 45 (90%) women revealed absent or mild dyspareunia, 46 (92%) women revealed absent or mild chronic pelvic pain, 48 (96%) women revealed absent or mild dyschezia. Conclusions Surgical management of DPE could be a radical approach for this disease but conservative for the patients, ensuring good improvement in symptoms and good patient satisfaction, and only performing vaginal or rectal exeresis when strictly necessary.


2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Zahra Dehbashi ◽  
Shaheen Khazali ◽  
Fateme Davari Tanha ◽  
Farnaz Mottahedian ◽  
Mahsa Ghajarzadeh ◽  
...  

Abstract Background Endometriosis can exert obvious negative effects on women’s quality of life. Excisional surgery is among the most effective treatments for severe pelvic endometriosis. The prevalence of severe pelvic adhesions following a laparoscopic examination of severe endometriosis varies between 50 and 100%. Temporary intraoperative ovarian suspension is a method for the reduction of adhesions is in the treatment of severe pelvic endometriosis. Given the importance and the prevalence of endometriosis and its complications, we conducted the present study to determine more effective adhesion-reducing methods with a view to improving the quality of the treatments provided. Methods The present prospective double-blind randomized clinical trial was conducted on 50 women of reproductive age (≥ 19 years) diagnosed with severe pelvic endometriosis on transvaginal ultrasound scans and vaginal examinations at Yas Hospital between 2014 and 2017. Women with severe endometriosis (stage III, stage IV, and deep infiltrating endometriosis) requiring an extensive bilateral dissection of the pelvic walls and the rectovaginal space, with preserved uterus and ovaries, were included in the study. The preoperative severity of ovarian adhesions was assessed in terms of ovarian motility, measured through a combination of gentle pressures applied with the vaginal probe and abdominal pressures applied with the examiner’s free hand. A table of random numbers was used to choose which ovary to suspend. The entire study population received standard general anesthesia. In the laparoscopic examination of the cases with severe endometriosis, both ovaries were routinely suspended to the anterior abdominal wall with PROLENE sutures. At the end of the surgery, one of the ovaries was kept suspended for 7 days, whereas the other ovarian suspension suture was cut. At 3 months postoperatively, all the patients underwent ultrasound scans for the assessment of ovarian motility and adhesions. The severity of pelvic pain was defined according to a visual analog score. After surgery, infertile women were followed for 2-4 years, and were contacted regarding the infertility treatment. Chemical and clinical pregnancy rates was compered between the two groups. Results Three months after laparoscopy, the adhesions were mild in 41 (82%) patients and moderate in 9 (18%) on the suspended side, and mild in 12 (24%) patients and moderate in 38 (76%) on the control side (P < 0.001). The mean dysmenorrhea score was 6.8 ± 1.5 before surgery and 4.5 ± 1.4 after surgery (P < 0.001). The chemical pregnancy rate and clinical pregnancy rate were not different in the suspended and control groups (P = 0. 62, P = 0.64). Conclusions The reduction in adhesions via ovarian suspension surgery promises reductions in the complications of endometriosis.


Author(s):  
PAG Ribeiro ◽  
RA Almeida-Prado ◽  
T Aoki ◽  
N Donadio ◽  
TA Ferreira ◽  
...  

Author(s):  
PA Ayroza Galvao Ribeiro ◽  
HSA Silveira ◽  
G Kamergorodsky ◽  
NB Lemos ◽  
RA Almeida-Prado ◽  
...  

2015 ◽  
Vol 45 (3) ◽  
pp. 355-356 ◽  
Author(s):  
M. Noventa ◽  
C. Saccardi ◽  
P. Litta ◽  
M. Quaranta ◽  
D. D'Antona ◽  
...  

2010 ◽  
Vol 36 (2) ◽  
pp. 241-248 ◽  
Author(s):  
T. K. Holland ◽  
J. Yazbek ◽  
A. Cutner ◽  
E. Saridogan ◽  
W. L. Hoo ◽  
...  

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Agnieszka Bianek-Bodzak ◽  
Edyta Szurowska ◽  
Sambor Sawicki ◽  
Marcin Liro

MR imaging is becoming increasingly important in the assessment of patients with endometriosis. Its multiplanar capabilities and superior soft tissue contrast are particularly useful in the detection of deep infiltrating endometriotic implants. Endometriosis, defined as the presence of endometrial glands and stroma outside the endometrium, is among the most common gynaecological disorders affecting women in their reproductive age. The diagnosis and evaluation of the extension of endometriosis are difficult only with physical examination and laparoscopy. According to the authors’ personal experience, a special MRI technique and some imaging guidelines regarding different anatomical localizations of endometriosis are discussed. This review is a brief presentation of current evidence on the diagnostic accuracy of MRI in the evaluation of endometriosis concerning other diagnostic methods, the limitations of MRI and its essential usefulness for preoperative diagnosis of deep pelvic endometriosis, and future perspectives in monitoring this disease.


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