Prediction of endometriosis by transvaginal ultrasound in reproductive-age women with normal ovarian size

Said, Tamer H.; Azzam, Amal Z.

doi:10.1016/j.mefs.2013.11.003

Cited by 9 publications

(11 citation statements)

References 27 publications

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“…Most importantly, ovarian fixation should trigger referral for a thorough pelvic ultrasound evaluation for POD obliteration and pelvic DE nodules, as these features are significantly associated with fixed ovaries at TVU. The current study supports findings from previous studies; ovarian immobility appears to be an important soft marker for the prediction of the presence of endometriosis at surgery, as well as surgical difficulty 6, 9, 13 …”

Section: Discussionsupporting

confidence: 90%

Ovarian Immobility at Transvaginal Ultrasound: An Important Sonographic Marker for Prediction of Need for Pelvic Sidewall Surgery in Women With Suspected Endometriosis

Rao

Condous

Reid

2021

J of Ultrasound Medicine

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Objectives-To determine whether ovarian fixation at transvaginal ultrasound (TVU) is a marker for a need for laparoscopic pelvic sidewall surgery (ie, ureterolysis or dissection of adhesions involving the pelvic sidewall). The relationship between ovarian immobility at TVU with respect to endometriosis staging using the revised American Fertility Society (r-AFS) classification was also evaluated.Methods-Retrospective diagnostic accuracy study was performed in a tertiary referral hospital and two private hospitals. Sixty-six women with pelvic pain underwent detailed TVU preoperatively followed by laparoscopic endometriosis surgery. TVU ovarian mobility findings (ie, mobile versus fixed ovary) were compared to surgical findings, the need for laparoscopic pelvic sidewall surgery and r-AFS score (I-IV).Results-Complete ultrasound and surgical data were available for 66 of 77 (86%) women. Twenty-six of 66 (40%) had isolated superficial peritoneal endometriosis, 15 of 66 (23%) had ovarian endometrioma (OE), 13 of 66 (20%) had pelvic deep endometriosis (DE). Twenty-seven of 66 (41%) had ovarian fixation at TVU. The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of ovarian fixation at TVU for the prediction of need for laparoscopic pelvic sidewall surgery was 71%, 61%, 86%, 85%, and 62%, respectively (P = .0002). Ovarian fixation at TVU was significantly associated with the presence of ipsilateral OE, pouch of Douglas obliteration, pelvic DE nodules, and r-AFS stage III/IV (moderate/severe) endometriosis (all P-values <.05).Conclusions-Ovarian fixation at TVU appears to be a marker for moderate/ severe endometriosis and the need for laparoscopic pelvic sidewall surgery. This sign may be a valuable "red flag" for identifying women at increased risk of requiring an advanced laparoscopic surgeon, and in turn, improve surgical planning.

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Section: Discussionsupporting

confidence: 90%

Ovarian Immobility at Transvaginal Ultrasound: An Important Sonographic Marker for Prediction of Need for Pelvic Sidewall Surgery in Women With Suspected Endometriosis

Rao

Condous

Reid

2021

J of Ultrasound Medicine

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“…The authors diagnosed endometriosis in 54.4% patients. 15 Another study by Menakaya et al 16 reported that TVS is 72.2% to 86.8% sensitive and 96.9% to 98.3% specific for diagnosis of endometriosis depending upon the location of the lesions.…”

Section: Discussionmentioning

confidence: 98%

“…A study conducted by Said TH & Azam AZ 15 on accuracy of TVS in diagnosing endometriosis reported that TVS as 97.3% sensitive and 98.5% specific. The authors diagnosed endometriosis in 54.4% patients.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of Transvaginal Ultrasonography for Diagnosis of Endometriosis Taking Laparoscopy as Gold Standard

Nighat¹,

Anwar²,

Anwar³

et al. 2020

BIOMEDICA

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Background and Objective: Endometriosis is a common gynaecological disease with a diverse clinical presentation. Laparoscopy has long been considered the gold standard diagnostic modality for endometriosis but with the evolution of non-invasive, high resolution transvaginal ultrasonography, it is frequently used as the first line diagnostic technique in making a preoperative diagnosis for endometriosis. This study was designed to determine the diagnostic accuracy of transvaginal ultrasonography (TVS) in diagnosis of endometriosis taking laparoscopy as gold standard.Methods: A total of 118 women of child bearing age who presented with symptoms of pelvic endometriosis in the department of gynecology, Bakhtawar Amin Hospital Multan were included. The study duration was from June 01, 2018 to May 31, 2020. Patients were first investigated on TVS examination to diagnose endometriosis. Afterwards, diagnostic laparoscopy was performed in all patients to confirm the diagnosis of endometriosis. Accuracy of TVS was determined in terms of sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV).Results: Mean age of the patients was 31.7 ± 7.4 years. Most common presenting complaint was dysmenorrhea in 89 (75.4%) patients followed by dyspareunia in 36 (30.5%), chronic pelvic pain in 30 (25.4%) patients and subfertility in 18 (15.3%) patients. On TVS, endometriosis was diagnosed in 69 (58.5%) patients. While on diagnostic laparoscopy, endometriosis was diagnosed in 75 (63.6%) patients. The sensitivity of TVS in diagnosis of endometriosis was calculated as 82.7%, specificity as 83.7%, PPV as 89.9% and NPV as 73.5%. Conclusion:TVS appears to be the alternative and safe modality for diagnosis of endometriosis. It can be used as an alternative to diagnostic laparoscopy for the early diagnosis of endometriosis. It has a good sensitivity and specificity for diagnosis of endometriosis.

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“…It is well documented that TVUS is characterised by high sensitivity and specificity regarding ovarian endometriosis diagnosis 23 . However, in some cases endometriotic implants (superficial or deep) might be so small and thus not easily detected by standard TVUS 24,25 . Significant efforts towards improving TVUS markers are being made 25,26 .…”

Section: Discussionmentioning

confidence: 99%

“…However, in some cases endometriotic implants (superficial or deep) might be so small and thus not easily detected by standard TVUS 24,25 . Significant efforts towards improving TVUS markers are being made 25,26 . In light of the above, should diagnosis of unexplained infertility or male factor infertility cases presenting with repeated implantation failure, alarm clinicians?…”

Section: Discussionmentioning

confidence: 99%

Couples with mild male factor infertility and at least 3 failed previous IVF attempts may benefit from laparoscopic investigation regarding assisted reproduction outcome

Pantou¹,

Sfakianoudis²,

Maziotis

et al. 2020

Sci Rep

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the aim of this study is to assess the value of laparoscopy for couples diagnosed with mild male factor infertility and at least three previous failed In-Vitro Fertilization (IVF) attempts. A total of 169 couples were included in this prospective cohort study. patients were presented with the option of being subjected to laparoscopic investigation for correction of previously unidentified endometriosis or pelvic adhesions. The outcome measures were Live Birth/Ongoing Pregnancy, clinical pregnancy and positive hCG rate. One-hundred and one of them opted for, whereas 68 opted against laparoscopic investigation. All patients proceeded with a single ICSI cycle. Following laparoscopic investigation, 43 patients were diagnosed with endometriosis, 22 with adhesions, while for 36 patients laparoscopic investigation provided no further diagnosis. No statistically significant differences were observed regarding baseline hormonal levels and other characteristics between the two groups and the three subgroups. When compared to the no-laparoscopy group, women subjected to laparoscopy presented with a higher clinical pregnancy and ongoing pregnancy/live birth rate. following endometriosis correction, a marginally non-statistically significant trend was observed regarding a decrease in poorquality blastocysts (p = 0.056). A statistically significant higher clinical pregnancy (p = 0.03) and ongoing pregnancy/live birth rate was observed in the endometriosis group when compared to male factor infertility only (p = 0.04). Laparoscopic identification and correction of undiagnosed endometriosis in couples initially diagnosed with male infertility and at least 3 failed previous IVF attempts, appears to be a promising approach efficiently addressing infertility for these patients while avoiding IVF overuse.Male factor infertility stands as a common infertility etiology, identified in up to 50% of infertile couples 1 , as the sole etiology or coupled with female factor infertility. Studies on male factor infertility, provide robust data that this may be successfully managed through in vitro fertilization (IVF) treatment, ensuring high implantation and pregnancy rates 2 . In fact, even severe and challenging cases of male factor infertility could be effectively managed, through the employment of a wide pallet of techniques improving standard employment of Intracytoplasmic Sperm Injection (ICSI) along with fertilization rates 3 . Male infertility has been categorized as mild, moderate or severe 4 . Mild male factor infertility does not present with a strict definition, including a range of different

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Prediction of endometriosis by transvaginal ultrasound in reproductive-age women with normal ovarian size

Cited by 9 publications

References 27 publications

Ovarian Immobility at Transvaginal Ultrasound: An Important Sonographic Marker for Prediction of Need for Pelvic Sidewall Surgery in Women With Suspected Endometriosis

Ovarian Immobility at Transvaginal Ultrasound: An Important Sonographic Marker for Prediction of Need for Pelvic Sidewall Surgery in Women With Suspected Endometriosis

Accuracy of Transvaginal Ultrasonography for Diagnosis of Endometriosis Taking Laparoscopy as Gold Standard

Couples with mild male factor infertility and at least 3 failed previous IVF attempts may benefit from laparoscopic investigation regarding assisted reproduction outcome

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