Comparative analysis of techniques for diagnosing retrocervical endometriosis


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Abstract

Objective. To estimate the diagnostic informative value of instrumental examinations in patients with retrocervical endometriosis (RCE). Subjects and methods. According to the extent of RCE and a concurrence of pelvic organ diseases, 120 patients were divided into 4 subgroups: IA) 30patients with RCE; IB) 30patients with RCE and with colon involvement; IC) 30 patients with RCE and endometrioid ovarian cyst; ID) 30 patients with RCE concurrent with uterine myoma. The extent of RCE was determined according to the data of gynecological examination, transvaginal ultrasound (TVUS), MRI, magnetic resonance imaging (MRT), colonoscopy, laparoscopy, and histological examination of surgical material. Results. TVUS was more informative in endometrioid ovarian cysts (95%) and intestinal lesions (87.3%) than in the isolated form of RCE (68.75%). MRI had the highest diagnostic value in identifying endometrioid infiltrates spreading to the intestinal wall (98.6%), or ovarian lesions (97.4%). The sensitivity of TVUS and MRI in uterine fibroids concurrent with RCE was 36.6% and 89.6%, respectively. Both TVUS and MRI in unobvious pelvic adhesions were uninformative (29.13% and 59.23%, respectively). Conclusion. Only laparoscopy enables full visualization of a pathological focus and access to organs. One should not deemphasize the role of preoperative examination including TVUS, MRI, and colonoscopy. Each of the techniques has its own diagnostic value and does not replace, but provides additional information.

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About the authors

I. K Almova

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: www.gold11@mail
postgraduate student of the Surgery Department 117997, Russia, Moscow, Ac. Oparina str. 4

E. G Khilkevich

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: e_khilkevich@oparina4.ru
MD, obstetrician-gynecologist of the Surgery Department 117997, Russia, Moscow, Ac. Oparina str. 4

V. D Chuprynin

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: v_chuprynin@oparina4.ru
PhD, Head of the Surgery Department 117997, Russia, Moscow, Ac. Oparina str. 4

I. S Balashov

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: i_balashov@oparina4.ru
Researcher of Biostatistics Laboratory 117997, Russia, Moscow, Ac. Oparina str. 4

A. S Gus

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: a_gus@oparina4.ru
MD, Head of Functional Diagnostics at the Department of Diagnostic Imaging 117997, Russia, Moscow, Ac. Oparina str. 4

V. A Bychenko

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: v_bychenko@oparina4.ru
M.D., Ph.D., Head of the Radiology Department 117997, Russia, Moscow, Ac. Oparina str. 4

R. B Matronitsky

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: r_matronitskiy@oparina4.ru
endoscopist doctor of the Surgery Department 117997, Russia, Moscow, Ac. Oparina str. 4

V. N Serov

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: v_serov@oparina4.ru
MD, Professor, Academician of the Russian Academy of Sciences 117997, Russia, Moscow, Ac. Oparina str. 4

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