Rectovaginal endometriosis: head to head comparison between sonovaginography and magnetic resonance imaging

Background: Rectovaginal endometriosis (RVE) is a severe form of deep pelvic endometriosis associated with dysmenorrhoea, pelvic pain, and dyspareunia. Diagnosis of RVE is a challenge for clinicians. Aim of outhe present study was to compare the diagnostic accuracy of sonovaginography with MRI on a consecutive cohort of women referred to this institution due to RVE suspect. Materials and Methods: The authors performed a retrospective study on consecutive patients undergoing surgery at this Unit due to a suspicion of RVE. All women were subject to MRI and sonovaginography. Primary endpoint was to compare the diagnostic accuracy of sonovaginography and MRI in the detection of RVE. Results: RVE was diagnosed (with surgery plus histology) in 60 women. In all cases, the surgical procedure was completed without complications. Sonovaginography and MRI showed high sensitivity (95% vs. 81.7%) and similar specificity (93.8% and 91.2%, respectively) in the diagnosis of RVE. Conclusions: Sonovaginography, when performed by an expert sonographer, may represent a valid alternative to MRI for the diagnosis of RVE, with lower costs and minimal time consumption.