Getting help from water to replace colonoscopy and MRI for the diagnosis of deep bowel endometriosis.

Rectal Water Contrast Transvaginal Ultrasound: A Promising Tool for Assessing Deep Bowel Endometriosis

Key Points

Highlights:

• Rectal water contrast transvaginal ultrasound (RWC-TVS) is a minimally invasive procedure that can be used to assess "Deep Bowel Endometriosis".
• RWC-TVS is less expensive and more readily available than MRI, and it does not require the same level of bowel preparation as a colonoscopy.

Importance:

• "Deep Bowel Endometriosis" is a challenging condition to diagnose and treat, and accurate assessment is critical to guiding surgical treatment and improving outcomes.
• RWC-TVS has the potential to be a valuable tool for its assessment.

What's done here:                                  

• The study aimed to assess the accuracy and feasibility of RWC-TVS as a tool for the assessment of "Deep Bowel Endometriosis".
• Thirty-one women with suspected "Deep Bowel Endometriosis" underwent RWC-TVS to assess the extent and severity of their condition.
• The patients were evaluated using a standardized protocol that included detailed mapping of any endometriosis lesion identified during the procedure.
• The measurements by RWC-TS were compared with the sizes of excised specimens postoperatively.

Key Results:

• RWC-TVS was highly effective in identifying and mapping endometriosis lesions in the bowel.
• In 30 of the 31 patients, the RWC-TVS findings were consistent with the surgical findings, indicating a high degree of accuracy.
• The difference between the mean dimension of the nodules measured via RWC-TVS and histopathological examination was insignificant.
• RWC-TVS was well-tolerated by patients, with no serious adverse events reported.

Limitations:

• The study had a relatively small sample size and was conducted at a single institution, which may limit the generalizability of the findings.
• The study did not compare RWC-TVS to other imaging modalities or evaluate its impact on surgical outcomes.

Lay Summary

This retrospective study by Martyna Masternak et al. discusses the use of rectal water contrast transvaginal ultrasound (RWC-TVS) as a tool for assessing deep bowel endometriosis.

The study explains how the procedure is minimally invasive, and how it involves filling the rectum with water and using transvaginal ultrasound to visualize the bowel. This technique allows for the detection and mapping of "deep bowel endometriosis" lesions, which can then be used to guide surgical treatment and might replace MRI and colonoscopy.

After filling the rectum with water, the technique then visualizes the bowel using a transvaginal ultrasound probe. The water acts as a contrast medium, making it easier to identify and map endometriosis lesions on the bowel wall. The procedure is performed with the patient in a lithotomy position, and a sterile ultrasound probe is inserted into the vagina. The rectum is then filled with water using a syringe, and the ultrasound probe is used to visualize the bowel.

The study involved 31 women with suspected deep bowel endometriosis who underwent RWC-TVS to assess the extent and severity of their condition. The study was conducted at a single institution in Poland, and all procedures were performed by the same experienced sonographer. The results showed that RWC-TVS was highly effective in identifying and mapping endometrial lesions in the bowel. In 30 of the 31 patients, the RWC-TVS findings were consistent with the surgical findings, indicating a high degree of accuracy. The study also found that RWC-TVS was well-tolerated by patients, with no serious adverse events reported.

Overall, the study published in MDPI-Life suggests that RWC-TVS is a valuable tool for the assessment of deep bowel endometriosis. The technique is minimally invasive, accurate, and well-tolerated, and can help guide surgical treatment and improve outcomes for women with deep bowel endometriosis.

Research Source: https://pubmed.ncbi.nlm.nih.gov/37240796/