Diagnosis of pelvic adhesions in patients with endometrioma: the role of transvaginal ultrasonography
Objective To estimate the diagnostic value of transvaginal ultrasonography in the detection of pelvic adhesions in women suspected of having endometriomas at ultrasonography. Design Prospective observational study. Setting Academic Department of Obstetrics and Gynecology. Patient(s) One hundred thir...
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| Veröffentlicht in: | Fertility and sterility 2010-07, Vol.94 (2), p.742-746 |
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| creator | Guerriero, Stefano, M.D Ajossa, Silvia, M.D Garau, Nicoletta, M.D Alcazar, Juan Luis, M.D Mais, Valerio, M.D Melis, Gian Benedetto, M.D |
| description | Objective To estimate the diagnostic value of transvaginal ultrasonography in the detection of pelvic adhesions in women suspected of having endometriomas at ultrasonography. Design Prospective observational study. Setting Academic Department of Obstetrics and Gynecology. Patient(s) One hundred thirteen women who underwent surgery for an endometrioma. Intervention(s) All patients underwent transvaginal ultrasonography before surgery, and at ultrasonography the presence of fixation of the ovary to the uterus was considered characteristic of the presence of pelvic adhesions. Main Outcome Measure(s) Sensitivity, specificity, and likelihood ratios were calculated with 95% confidence intervals (CIs). Result(s) The sensitivity and specificity of the fixation to the uterus of at least one ovary were respectively 89% (95% CI 84%–92%) and 90% (95% CI 76%–97%). The likelihood ratio for fixation of at least one ovary to the uterus was 8.92 (95% CI 3.04–26) and for a “normal” ultrasound examination 0.12 (95% CI 0.06–0.23). The pretest probability of pelvic adhesions was 74%, and this probability increased to 96% when fixation of at least one ovary to the uterus was present and fell to 27% when this ultrasonographic finding was absent. Conclusion(s) Transvaginal ultrasonography seems to be able to detect or exclude the presence of adhesions in women with ultrasonographic suspicion of endometrioma. |
| doi_str_mv | 10.1016/j.fertnstert.2009.03.035 |
| format | Article |
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Design Prospective observational study. Setting Academic Department of Obstetrics and Gynecology. Patient(s) One hundred thirteen women who underwent surgery for an endometrioma. Intervention(s) All patients underwent transvaginal ultrasonography before surgery, and at ultrasonography the presence of fixation of the ovary to the uterus was considered characteristic of the presence of pelvic adhesions. Main Outcome Measure(s) Sensitivity, specificity, and likelihood ratios were calculated with 95% confidence intervals (CIs). Result(s) The sensitivity and specificity of the fixation to the uterus of at least one ovary were respectively 89% (95% CI 84%–92%) and 90% (95% CI 76%–97%). The likelihood ratio for fixation of at least one ovary to the uterus was 8.92 (95% CI 3.04–26) and for a “normal” ultrasound examination 0.12 (95% CI 0.06–0.23). The pretest probability of pelvic adhesions was 74%, and this probability increased to 96% when fixation of at least one ovary to the uterus was present and fell to 27% when this ultrasonographic finding was absent. Conclusion(s) Transvaginal ultrasonography seems to be able to detect or exclude the presence of adhesions in women with ultrasonographic suspicion of endometrioma.</description><identifier>ISSN: 0015-0282</identifier><identifier>EISSN: 1556-5653</identifier><identifier>DOI: 10.1016/j.fertnstert.2009.03.035</identifier><identifier>PMID: 19368917</identifier><identifier>CODEN: FESTAS</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Biological and medical sciences ; endometrioma ; Endometriosis - diagnostic imaging ; Female ; Female genital diseases ; Gynecology. Andrology. Obstetrics ; Humans ; Internal Medicine ; Medical sciences ; Middle Aged ; Non tumoral diseases ; Obstetrics and Gynecology ; Ovary - diagnostic imaging ; Pelvic adhesions ; Prospective Studies ; Reproducibility of Results ; sensitivity ; Sensitivity and Specificity ; Severity of Illness Index ; specificity ; Tissue Adhesions - diagnostic imaging ; transvaginal ultrasonography ; Ultrasonography - methods ; Ultrasonography - standards ; Uterus - diagnostic imaging ; Vagina - diagnostic imaging ; Young Adult</subject><ispartof>Fertility and sterility, 2010-07, Vol.94 (2), p.742-746</ispartof><rights>American Society for Reproductive Medicine</rights><rights>2010 American Society for Reproductive Medicine</rights><rights>2015 INIST-CNRS</rights><rights>Copyright 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c508t-279b982e52efe544798df06557ecef4c0e6ded968224ee0eb6e20e579f13b0443</citedby><cites>FETCH-LOGICAL-c508t-279b982e52efe544798df06557ecef4c0e6ded968224ee0eb6e20e579f13b0443</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0015028209006001$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23009727$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19368917$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Guerriero, Stefano, M.D</creatorcontrib><creatorcontrib>Ajossa, Silvia, M.D</creatorcontrib><creatorcontrib>Garau, Nicoletta, M.D</creatorcontrib><creatorcontrib>Alcazar, Juan Luis, M.D</creatorcontrib><creatorcontrib>Mais, Valerio, M.D</creatorcontrib><creatorcontrib>Melis, Gian Benedetto, M.D</creatorcontrib><title>Diagnosis of pelvic adhesions in patients with endometrioma: the role of transvaginal ultrasonography</title><title>Fertility and sterility</title><addtitle>Fertil Steril</addtitle><description>Objective To estimate the diagnostic value of transvaginal ultrasonography in the detection of pelvic adhesions in women suspected of having endometriomas at ultrasonography. Design Prospective observational study. Setting Academic Department of Obstetrics and Gynecology. Patient(s) One hundred thirteen women who underwent surgery for an endometrioma. Intervention(s) All patients underwent transvaginal ultrasonography before surgery, and at ultrasonography the presence of fixation of the ovary to the uterus was considered characteristic of the presence of pelvic adhesions. Main Outcome Measure(s) Sensitivity, specificity, and likelihood ratios were calculated with 95% confidence intervals (CIs). Result(s) The sensitivity and specificity of the fixation to the uterus of at least one ovary were respectively 89% (95% CI 84%–92%) and 90% (95% CI 76%–97%). The likelihood ratio for fixation of at least one ovary to the uterus was 8.92 (95% CI 3.04–26) and for a “normal” ultrasound examination 0.12 (95% CI 0.06–0.23). The pretest probability of pelvic adhesions was 74%, and this probability increased to 96% when fixation of at least one ovary to the uterus was present and fell to 27% when this ultrasonographic finding was absent. Conclusion(s) Transvaginal ultrasonography seems to be able to detect or exclude the presence of adhesions in women with ultrasonographic suspicion of endometrioma.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>endometrioma</subject><subject>Endometriosis - diagnostic imaging</subject><subject>Female</subject><subject>Female genital diseases</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Non tumoral diseases</subject><subject>Obstetrics and Gynecology</subject><subject>Ovary - diagnostic imaging</subject><subject>Pelvic adhesions</subject><subject>Prospective Studies</subject><subject>Reproducibility of Results</subject><subject>sensitivity</subject><subject>Sensitivity and Specificity</subject><subject>Severity of Illness Index</subject><subject>specificity</subject><subject>Tissue Adhesions - diagnostic imaging</subject><subject>transvaginal ultrasonography</subject><subject>Ultrasonography - methods</subject><subject>Ultrasonography - standards</subject><subject>Uterus - diagnostic imaging</subject><subject>Vagina - diagnostic imaging</subject><subject>Young Adult</subject><issn>0015-0282</issn><issn>1556-5653</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNklGL1DAQgIso3t7pX5C8iE9dJ2mTtj4IenoqHPigPodsOt3N2iZrJl3Zf2_KLh74JAwJA9_MhC9TFIzDmgNXr_frAWPylPK5FgDdGqoc8lGx4lKqUipZPS5WAFyWIFpxVVwT7QFA8UY8La54V6m2482qwA_ObH0gRywM7IDj0Vlm-h2SC56Y8-xgkkOfiP12acfQ92HCFF2YzBuWdshiGHGpTdF4Opqt82Zk85hTCj5soznsTs-KJ4MZCZ9f7pvix93H77efy_uvn77cvrsvrYQ2laLpNl0rUAocUNZ107X9AErKBi0OtQVUPfadaoWoEQE3CgWgbLqBVxuo6-qmeHXue4jh14yU9OTI4jgaj2Em3VSVkqJtIJPtmbQxEEUc9CG6ycST5qAXx3qvHxzrxbGGKofMpS8uQ-bNhP1D4UVqBl5eAEPWjEMWYx395USVmzVi4d6fOcxKjg6jJptVW-xdRJt0H9z_vObtP03s6LzLc3_iCWkf5pg_hDTXJDTob8tOLCsBXd6GnFR_AO9vts0</recordid><startdate>20100701</startdate><enddate>20100701</enddate><creator>Guerriero, Stefano, M.D</creator><creator>Ajossa, Silvia, M.D</creator><creator>Garau, Nicoletta, M.D</creator><creator>Alcazar, Juan Luis, M.D</creator><creator>Mais, Valerio, M.D</creator><creator>Melis, Gian Benedetto, M.D</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20100701</creationdate><title>Diagnosis of pelvic adhesions in patients with endometrioma: the role of transvaginal ultrasonography</title><author>Guerriero, Stefano, M.D ; Ajossa, Silvia, M.D ; Garau, Nicoletta, M.D ; Alcazar, Juan Luis, M.D ; Mais, Valerio, M.D ; Melis, Gian Benedetto, M.D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c508t-279b982e52efe544798df06557ecef4c0e6ded968224ee0eb6e20e579f13b0443</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>endometrioma</topic><topic>Endometriosis - diagnostic imaging</topic><topic>Female</topic><topic>Female genital diseases</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Non tumoral diseases</topic><topic>Obstetrics and Gynecology</topic><topic>Ovary - diagnostic imaging</topic><topic>Pelvic adhesions</topic><topic>Prospective Studies</topic><topic>Reproducibility of Results</topic><topic>sensitivity</topic><topic>Sensitivity and Specificity</topic><topic>Severity of Illness Index</topic><topic>specificity</topic><topic>Tissue Adhesions - diagnostic imaging</topic><topic>transvaginal ultrasonography</topic><topic>Ultrasonography - methods</topic><topic>Ultrasonography - standards</topic><topic>Uterus - diagnostic imaging</topic><topic>Vagina - diagnostic imaging</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Guerriero, Stefano, M.D</creatorcontrib><creatorcontrib>Ajossa, Silvia, M.D</creatorcontrib><creatorcontrib>Garau, Nicoletta, M.D</creatorcontrib><creatorcontrib>Alcazar, Juan Luis, M.D</creatorcontrib><creatorcontrib>Mais, Valerio, M.D</creatorcontrib><creatorcontrib>Melis, Gian Benedetto, M.D</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Fertility and sterility</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Guerriero, Stefano, M.D</au><au>Ajossa, Silvia, M.D</au><au>Garau, Nicoletta, M.D</au><au>Alcazar, Juan Luis, M.D</au><au>Mais, Valerio, M.D</au><au>Melis, Gian Benedetto, M.D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diagnosis of pelvic adhesions in patients with endometrioma: the role of transvaginal ultrasonography</atitle><jtitle>Fertility and sterility</jtitle><addtitle>Fertil Steril</addtitle><date>2010-07-01</date><risdate>2010</risdate><volume>94</volume><issue>2</issue><spage>742</spage><epage>746</epage><pages>742-746</pages><issn>0015-0282</issn><eissn>1556-5653</eissn><coden>FESTAS</coden><abstract>Objective To estimate the diagnostic value of transvaginal ultrasonography in the detection of pelvic adhesions in women suspected of having endometriomas at ultrasonography. Design Prospective observational study. Setting Academic Department of Obstetrics and Gynecology. Patient(s) One hundred thirteen women who underwent surgery for an endometrioma. Intervention(s) All patients underwent transvaginal ultrasonography before surgery, and at ultrasonography the presence of fixation of the ovary to the uterus was considered characteristic of the presence of pelvic adhesions. Main Outcome Measure(s) Sensitivity, specificity, and likelihood ratios were calculated with 95% confidence intervals (CIs). Result(s) The sensitivity and specificity of the fixation to the uterus of at least one ovary were respectively 89% (95% CI 84%–92%) and 90% (95% CI 76%–97%). The likelihood ratio for fixation of at least one ovary to the uterus was 8.92 (95% CI 3.04–26) and for a “normal” ultrasound examination 0.12 (95% CI 0.06–0.23). The pretest probability of pelvic adhesions was 74%, and this probability increased to 96% when fixation of at least one ovary to the uterus was present and fell to 27% when this ultrasonographic finding was absent. Conclusion(s) Transvaginal ultrasonography seems to be able to detect or exclude the presence of adhesions in women with ultrasonographic suspicion of endometrioma.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>19368917</pmid><doi>10.1016/j.fertnstert.2009.03.035</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Biological and medical sciences endometrioma Endometriosis - diagnostic imaging Female Female genital diseases Gynecology. Andrology. Obstetrics Humans Internal Medicine Medical sciences Middle Aged Non tumoral diseases Obstetrics and Gynecology Ovary - diagnostic imaging Pelvic adhesions Prospective Studies Reproducibility of Results sensitivity Sensitivity and Specificity Severity of Illness Index specificity Tissue Adhesions - diagnostic imaging transvaginal ultrasonography Ultrasonography - methods Ultrasonography - standards Uterus - diagnostic imaging Vagina - diagnostic imaging Young Adult |
| title | Diagnosis of pelvic adhesions in patients with endometrioma: the role of transvaginal ultrasonography |
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