Can transvaginal sonography predict infiltration depth in patients with deep infiltrating endometriosis of the rectum?

Background: Patients with deep infiltrating endometriosis (DIE) of the rectum often benefit from surgical treatment, including disc or segmental bowel resection, in terms of pain relief and treatment of infertility. The aim of the present study was to evaluate the diagnostic accuracy of transvaginal sonography (TVS) for preoperative detection of rectal DIE. Furthermore, we aimed to investigate whether TVS can predict infiltration depth based on the distortion of characteristic sonomorphologic features of the rectal wall.

Combination of transvaginal sonography and clinical examination for preoperative diagnosis of pelvic endometriosis.

Background: The aim of the present study was to evaluate the accuracy of routine clinical examination (per vaginam, PV) combined with transvaginal sonography (TVS) for presurgical, non-invasive diagnosis of endometriosis.

Methods: Two-hundred women with symptoms suggestive of endometriosis were prospectively assessed by PV and TVS prior to laparoscopy and radical resection of disease and histological confirmation.

Results: Prevalence of endometriosis on the right/left (r/l) ovary, r/l uterosacral ligament (USL), pouch of Douglas (POD), vagina, bladder, rectovaginal space (RVS) and rectum was 12%, 13%, 12%, 22%, 15%, 11%, 2%, 4% and 24%.

[ENZIAN-score, a classification of deep infiltrating endometriosis].

The ENZIAN-Score is presented as a new instrument to classify the deep infiltrating endometriosis. Especially the retroperitoneal part of the severe endometriosis is focussed on. In analogy to an oncological staging four different stages are pronounced.

Reduction of postoperative adhesion formation after laparoscopic ovarian cystectomy.

The purpose of this randomized, open-label study was to assess the efficacy of the product Interceed absorbable adhesion barrier in the prevention of adhesion formation on the ovary after laparoscopic ovarian cystectomy. A total of 25 patients requiring laparoscopic bilateral ovarian cystectomy were enrolled into this study. After removal of ovarian cysts, peri-adnexal adhesions, and peritoneal irrigants, and the attainment of meticulous haemostasis, the random assignment of one ovary for wrapping with Interceed was revealed to the surgeon.

Laparoscopic creation of a neovagina: modified Vecchietti method.

A new surgical technique for the treatment of vaginal aplasia is described. It consists of a modification of Vecchietti's method, allowing laparoscopic performance of the operation. 9 patients have been treated in this way since January, 1991 with good results.