TY  - JOUR
AU  - Hudelist, Gernot
AU  - Ballard, K.
AU  - English, J.
AU  - Wright, J.
AU  - Banerjee, S.
AU  - Mastoroudes, H.
AU  - Thomas, A.
AU  - Singer, C. F.
AU  - Keckstein, J.
TI  - Transvaginal sonography vs. clinical examination in the preoperative diagnosis of deep infiltrating endometriosis
JF  - ULTRASOUND IN OBSTETRICS AND GYNECOLOGY
J2  - ULTRASOUND OBSTET GYNECOL
VL  - 37
PY  - 2011
IS  - 4
SP  - 480
EP  - 487
PG  - 8
SN  - 0960-7692
DO  - 10.1002/uog.8935
UR  - https://m2.mtmt.hu/api/publication/33975576
ID  - 33975576
N1  - Department of Obstetrics and Gynaecology, Endometriosis and Pelvic Pain Clinic, Wilhelminen Hospital, Montleartstrasse 37, 1160 Vienna, Austria            
            Stiftung Endometriose-Forschung (SEF), University of Surrey, Guildford, United Kingdom            
            Postgraduate Medical School, University of Surrey, Guildford, United Kingdom            
            Department of Obstetrics and Gynaecology, Worthing and Southlands Hospital, Worthing, United Kingdom            
            Department of Obstetrics and Gynaecology, Ashford and St Peters Hospital, Chertsey, United Kingdom            
            Department of Psychology, Alps Adria University, Klagenfurt, Austria            
            Department of Special Gynaecology, University of Vienna, Vienna, Austria            
            Center for Endometriosis, Villach Hospital, Villach, Austria            
            Cited By :142            
            Export Date: 14 June 2023            
            CODEN: UOGYF            
            Correspondence Address: Hudelist, G.; Department of Obstetrics and Gynaecology, Montleartstrasse 37, 1160 Vienna, Austria; email: gernot_hudelist@yahoo.de
AB  - Objective The aim of this study was to compare the diagnostic performance of clinical vaginal examination with that of transvaginal sonography (TVS) in the presurgical diagnosis of deep infiltrating endometriosis. Methods One-hundred and fifty-five women with symptoms suggestive of endometriosis were included. One-hundred and twenty-nine patients met the inclusion criteria and were prospectively and independently assessed by vaginal examination and TVS prior to a diagnostic laparoscopy and, where appropriate, radical resection and histological confirmation of endometriosis was performed. Sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV) and positive and negative likelihood ratios (LR+ and LR-) were calculated for each test method. Results In total, 83 (64%) women had histological confirmation of endometriosis, 52 (40%) of whom had deep infiltrating endometriosis. The prevalence of endometriosis on the uterosacral ligaments, pouch of Douglas, vagina, bladder, rectovaginal space and rectosigmoid was 23.3%, 16.3%, 8.5%, 3.1%, 6.9% and 24%. PPV, NPV, LR+ and LR- for vaginal examination were 92%, 87%, 41.56 and 0.60 for ovarian endometriosis; 43%, 84%, 2.48 and 0.63 for uterosacral ligament disease; 64%, 95%, 9.14 and 0.26 for involvement of the pouch of Douglas; 80%, 97%, 42.91 and 0.28 for vaginal endometriosis; 78%, 98%, 46.67 and 0.23 for endometriosis of the rectovaginal space; 100%, 98%, 75.60 and 0.75 for bladder involvement; 86%, 84%, 18.97 and 0.63 for rectosigmoidal endometriosis. Values for TVS were similar with regard to vaginal and rectovaginal space endometriosis, but were clearly superior to vaginal examination in cases of ovarian (87%, 99%, 24.56 and 0.04), uterosacral ligament (91%, 90%, 31.35 and 0.37) and rectosigmoidal (97%, 97%, 88.51 and 0.1) endometriosis. Conclusions TVS is a more useful test than is vaginal examination in detecting endometriosis in the ovaries and rectosigmoid. Copyright (C) 2011 ISUOG. Published by John Wiley & Sons, Ltd.
LA  - English
DB  - MTMT
ER  -