{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T23:16:54Z","timestamp":1783466214078,"version":"3.55.0"},"reference-count":26,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,2,1]],"date-time":"2021-02-01T00:00:00Z","timestamp":1612137600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To analyze the effect of bowel preparation prior to transvaginal ultrasound (TVS) examination on the detection of bowel involvement and the description of rectosigmoid nodules of deep infiltrating endometriosis (DIE), and to evaluate patient tolerance of bowel preparation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective study of paired data obtained between September 2015 and March 2016 from a cohort of women referred, on suspicion of DIE but without surgical criteria, to the endometriosis unit of a tertiary university hospital. In all patients, the wall of the rectum and lower sigmoid colon was evaluated by two TVS examinations: the first was performed without bowel preparation and the second was done after the patient had followed a 3\u2010day low\u2010residue diet and received two 250\u2010mL enemas, one the night before TVS and the second 1\u20133\u2009h before the examination. The presence of adhesions, number and size of rectosigmoid nodules, deepest layer of the rectum affected, percentage of the circumference of the bowel affected and distance from the most caudal part of the bowel nodule to the anal verge were determined. Patient tolerance to bowel preparation was assessed using a 5\u2010point Likert scale, in which 1 represented \u2018very well tolerated\u2019 and 5 represented \u2018very poorly tolerated\u2019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean\u2009\u00b1\u2009SD age of the 110 patients included in the study was 36.8\u2009\u00b1\u20095.07\u2009years. As many as 55% of those identified during the first examination (TVS alone) as having adhesions were identified at the second examination (TVS with prior bowel preparation) as having rectosigmoid nodules, and 22 additional nodules were observed on TVS following bowel preparation. These newly detected rectosigmoid nodules, initially assessed mainly as adhesions, were smaller and more superficial compared with the nodules detected on TVS alone, or located in the anterior sigmoid wall. Patient tolerance overall to bowel preparation scored a mean of 1.81 on the 5\u2010point Likert scale.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Bowel preparation is well tolerated by patients. When bowel preparation is performed before TVS, the detection of small and superficial nodules and those in the anterior sigmoid wall is improved, allowing more detailed description of these nodules in patients with suspected endometriosis. Copyright \u00a9 2020 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.22058","type":"journal-article","created":{"date-parts":[[2020,4,29]],"date-time":"2020-04-29T22:28:52Z","timestamp":1588199332000},"page":"335-341","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Bowel preparation prior to transvaginal ultrasound improves detection of rectosigmoid deep infiltrating endometriosis and is well tolerated: prospective study of women with suspected endometriosis without surgical criteria"],"prefix":"10.1002","volume":"57","author":[{"given":"C.","family":"Ros","sequence":"first","affiliation":[{"name":"Endometriosis Unit, ICGON, Hospital Cl\u00ednic de Barcelona Universitat de Barcelona  Barcelona Spain"},{"name":"Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS)  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Rius","sequence":"additional","affiliation":[{"name":"Endometriosis Unit, ICGON, Hospital Cl\u00ednic de Barcelona Universitat de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. S.","family":"Abrao","sequence":"additional","affiliation":[{"name":"Endometriosis Section, Gynecologic Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina Universidade de S\u00e3o Paulo  S\u00e3o Paulo Brazil"},{"name":"Department of Obstetrics and Gynaecology S\u00e3o Paulo University  S\u00e3o Paulo Brazil"},{"name":"Gynecologic Division BP\u00a0\u2013\u00a0A Beneficencia Portuguesa de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"deGuirior","sequence":"additional","affiliation":[{"name":"Endometriosis Unit, ICGON, Hospital Cl\u00ednic de Barcelona Universitat de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. \u00c1.","family":"Mart\u00ednez\u2010Zamora","sequence":"additional","affiliation":[{"name":"Endometriosis Unit, ICGON, Hospital Cl\u00ednic de Barcelona Universitat de Barcelona  Barcelona Spain"},{"name":"Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS)  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Gracia","sequence":"additional","affiliation":[{"name":"Endometriosis Unit, ICGON, Hospital Cl\u00ednic de Barcelona Universitat de Barcelona  Barcelona Spain"},{"name":"Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS)  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0172-1761","authenticated-orcid":false,"given":"F.","family":"Carmona","sequence":"additional","affiliation":[{"name":"Endometriosis Unit, ICGON, Hospital Cl\u00ednic de Barcelona Universitat de Barcelona  Barcelona Spain"},{"name":"Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS)  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,2]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2017.10.026"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(02)03331-9"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deg152"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmv003"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15955"},{"key":"e_1_2_7_7_1","first-page":"105","article-title":"Ultrasound diagnosis of pelvic endometriosis","volume":"3","author":"Maiorana A","year":"2011","journal-title":"J Endometr Pelvic Pain Disord"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/det457"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/01443610701497660"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.8858"},{"key":"e_1_2_7_11_1","first-page":"CD009591","article-title":"Imaging modalities for the non\u2010invasive diagnosis of endometriosis","volume":"2","author":"Nisenblat V","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/den405"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dep433"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.7863\/ultra.33.2.315"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/den057"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2006.12.060"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2017.06.024"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19194"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2008.10.005"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.2011.05951.x"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2008.01.006"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmq057"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2017.12.025"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2008.07.1738"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000464"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.02.055"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2013.01.131"}],"container-title":["Ultrasound in Obstetrics &amp; 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