History, pelvic examination findings and mobility of ovaries as a sonographic marker to detect pelvic adhesions with fixed ovaries. Issue 3 (26th November 2013)

• Record Type: Journal Article
• Authors: Marasinghe, Jeevan Prasanga; Senanayake, Hemantha; Saravanabhava, Namasivayam; Arambepola, Carukshi; Condous, George; Greenwood, Peter
• Is Part Of: Journal of obstetrics and gynaecology research. Volume 40:Issue 3(2014:Mar.)
• Page Start: 785
• Page End: 790
• Publication Date: 2013-11-26
• Subjects: Gynecology -- Periodicals; Obstetrics -- Periodicals; 618.1005
• DOI: 10.1111/jog.12234
• Languages: English
• ISSNs: 1341-8076

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="jog12234-sec-0001" sec-type="section"> <title>Aim</title> <p>To compare the performance of history and examination findings combined with transvaginal ultrasound (TVS) 'soft marker' evaluation of ovarian mobility for the prediction of fixed ovaries secondary to endometriosis at laparoscopy.</p> </sec> <sec id="jog12234-sec-0002" sec-type="section"> <title>Methods</title> <p>This was a prospective observational study performed at the University Gynecology unit, National Hospital of Colombo Sri Lanka. Women who were scheduled for laparoscopic assessment of their pelvis to investigate subfertility or chronic pelvic pain were enrolled. All women underwent history evaluation for dysmenorrhea and dyspareunia, vaginal examination and detailed presurgical TVS. TVS was used to assess 'soft marker' of ovarian mobility. 'Fixed' ovaries on ultrasound were defined as one or other of the ovaries being fixed or adherent to the internal iliac artery or pelvic sidewall laterally or to the uterus medially. These findings were compared with 'fixed' ovaries confirmed at laparoscopy.</p> </sec> <sec id="jog12234-sec-0003" sec-type="section"> <title>Results</title> <p>A total of 106 patients were analyzed. Mean age was 33.3 years (standard deviation, 5.1). Sensitivity, specificity, positive and negative predictive values of each of the screening methods against laparoscopy in detecting endometriosis were as follows: dyspareunia, 45.9%, 76.8%, 51.5% and 72.6%; dysmenorrhea, 75.7%, 69.6%, 57.1% and 84.2%; positive vaginal examination, 73%, 88.4%, 77.1% and 85.9%; fixed ovaries with TVS, 78.4%, 94.2%, 87.9% and 89%; and a combination of history, examination findings and detection of fixed ovaries in TVS, 91.9%, 60.9%, 55.7% and 93.3%, respectively.</p> </sec> <sec id="jog12234-sec-0004" sec-type="section"> <title>Conclusion</title> <p>A combination of clinical and TVS‐based 'soft marker' of ovarian mobility provides a valid method for identifying fixed ovaries secondary to endometriosis.</p> </sec> </abstract>