Reproducibility of assessment of severity of pelvic endometriosis using transvaginal ultrasound

2013 ◽  
Vol 41 (2) ◽  
pp. 210-215 ◽  
Author(s):  
T. K. Holland ◽  
W. L. Hoo ◽  
D. Mavrelos ◽  
E. Saridogan ◽  
A. Cutner ◽  
...  
Keyword(s):  
Transvaginal Ultrasound ◽  
Pelvic Endometriosis

scholarly journals Effectiveness of ovarian suspension in preventing postoperative ovarian adhesions in patients with severe pelvic endometriosis—a case-control study

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Zahra Dehbashi ◽  
Shaheen Khazali ◽  
Fateme Davari Tanha ◽  
Farnaz Mottahedian ◽  
Mahsa Ghajarzadeh ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Transvaginal Ultrasound ◽  
Stage Iv ◽  
Clinical Pregnancy ◽  
Reproductive Age ◽  
Deep Infiltrating Endometriosis ◽  
Pelvic Endometriosis ◽  
Double Blind ◽  
Entire Study

Abstract Background Endometriosis can exert obvious negative effects on women’s quality of life. Excisional surgery is among the most effective treatments for severe pelvic endometriosis. The prevalence of severe pelvic adhesions following a laparoscopic examination of severe endometriosis varies between 50 and 100%. Temporary intraoperative ovarian suspension is a method for the reduction of adhesions is in the treatment of severe pelvic endometriosis. Given the importance and the prevalence of endometriosis and its complications, we conducted the present study to determine more effective adhesion-reducing methods with a view to improving the quality of the treatments provided. Methods The present prospective double-blind randomized clinical trial was conducted on 50 women of reproductive age (≥ 19 years) diagnosed with severe pelvic endometriosis on transvaginal ultrasound scans and vaginal examinations at Yas Hospital between 2014 and 2017. Women with severe endometriosis (stage III, stage IV, and deep infiltrating endometriosis) requiring an extensive bilateral dissection of the pelvic walls and the rectovaginal space, with preserved uterus and ovaries, were included in the study. The preoperative severity of ovarian adhesions was assessed in terms of ovarian motility, measured through a combination of gentle pressures applied with the vaginal probe and abdominal pressures applied with the examiner’s free hand. A table of random numbers was used to choose which ovary to suspend. The entire study population received standard general anesthesia. In the laparoscopic examination of the cases with severe endometriosis, both ovaries were routinely suspended to the anterior abdominal wall with PROLENE sutures. At the end of the surgery, one of the ovaries was kept suspended for 7 days, whereas the other ovarian suspension suture was cut. At 3 months postoperatively, all the patients underwent ultrasound scans for the assessment of ovarian motility and adhesions. The severity of pelvic pain was defined according to a visual analog score. After surgery, infertile women were followed for 2-4 years, and were contacted regarding the infertility treatment. Chemical and clinical pregnancy rates was compered between the two groups. Results Three months after laparoscopy, the adhesions were mild in 41 (82%) patients and moderate in 9 (18%) on the suspended side, and mild in 12 (24%) patients and moderate in 38 (76%) on the control side (P < 0.001). The mean dysmenorrhea score was 6.8 ± 1.5 before surgery and 4.5 ± 1.4 after surgery (P < 0.001). The chemical pregnancy rate and clinical pregnancy rate were not different in the suspended and control groups (P = 0. 62, P = 0.64). Conclusions The reduction in adhesions via ovarian suspension surgery promises reductions in the complications of endometriosis.

scholarly journals Value of transvaginal ultrasound in assessing severity of pelvic endometriosis

2010 ◽  
Vol 36 (2) ◽  
pp. 241-248 ◽  
Author(s):  
T. K. Holland ◽  
J. Yazbek ◽  
A. Cutner ◽  
E. Saridogan ◽  
W. L. Hoo ◽  
...  
Keyword(s):  
Transvaginal Ultrasound ◽  
Pelvic Endometriosis

scholarly journals Transvaginal ultrasound in deep endometriosis: pictorial essay

2019 ◽  
Vol 52 (5) ◽  
pp. 337-341 ◽  
Author(s):  
Jorge Gilmar Amaral de Oliveira ◽  
Vanessa Bonfada ◽  
Janice de Fátima Pavan Zanella ◽  
Janaina Coser
Keyword(s):  
Preoperative Planning ◽  
Low Cost ◽  
Transvaginal Ultrasound ◽  
Standard Test ◽  
Pelvic Endometriosis ◽  
First Line ◽  
Deep Endometriosis ◽  
Gold Standard Test ◽  
Pictorial Essay ◽  
Deep Pelvic Endometriosis

Abstract Endometriosis is characterized by the presence of endometrial tissue outside the uterus. When endometrial implants penetrate more than 5 mm into the peritoneum, the condition is referred to as deep pelvic endometriosis. Although laparoscopy is the gold standard test to establish a diagnosis of deep endometriosis, transvaginal ultrasound represents an alternative that can contribute to detection of the disease, because it is an accessible, low-cost, noninvasive examination that allows preoperative planning in cases requiring surgical treatment. However, in clinical practice, transvaginal ultrasound is still not widely used as the first-line examination in suspected cases of endometriosis. This essay describes the findings of deep endometriosis on transvaginal ultrasound, in order to disseminate knowledge of the utility of the technique for the diagnosis of this disease.

scholarly journals Transvaginal ultrasound (USTV) for Deep Pelvic Endometriosis: How “To Do” do it

2019 ◽  
Vol 45 ◽  
pp. S100-S101
Author(s):  
Maria Cristina Chammas ◽  
Ana Paula Klautau Leite ◽  
Sandra Monica Tochetto ◽  
Julia Diva Zavariz
Keyword(s):  
Transvaginal Ultrasound ◽  
Pelvic Endometriosis ◽  
Deep Pelvic Endometriosis

scholarly journals OP14.03: The inter‐ and intraobserver reproducibility of transvaginal ultrasound for pelvic endometriosis

2019 ◽  
Vol 54 (S1) ◽  
pp. 130-131
Author(s):  
E. Bean ◽  
P. Chaggar ◽  
N. Thanatsis ◽  
C. Bottomley ◽  
D. Jurkovic
Keyword(s):  
Transvaginal Ultrasound ◽  
Pelvic Endometriosis ◽  
Intraobserver Reproducibility

scholarly journals OC13.01: The value of transvaginal ultrasound in assessing the severity of pelvic endometriosis

2009 ◽  
Vol 34 (S1) ◽  
pp. 23-24
Author(s):  
T. K. Holland ◽  
J. Yazbek ◽  
W. Hoo ◽  
D. Mavrelos ◽  
D. Jurkovic
Keyword(s):  
Transvaginal Ultrasound ◽  
Pelvic Endometriosis

Deep Pelvic Endometriosis: From Diagnosis to Wellness

2009 ◽  
Vol 1 (3-4) ◽  
pp. 150-156 ◽  
Author(s):  
Carlo Saccardi ◽  
Andrea Cocco ◽  
Alberto Tregnaghi ◽  
Erich Cosmi ◽  
Nicola Baldan ◽  
...  
Keyword(s):  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Rectal Wall ◽  
Transvaginal Ultrasound ◽  
Vaginal Wall ◽  
Complete Separation ◽  
Pelvic Endometriosis ◽  
Laparoscopic Excision ◽  
Segmental Bowel Resection ◽  
Deep Pelvic Endometriosis

Purpose to determine the efficacy of laparoscopic excision of deep pelvic endometriosis (DPE). Methods One hundred and two highly symptomatic women with DPE underwent clinical examination, transvaginal ultrasound, nuclear magnetic resonance (NMR) and sonovaginography. Among the 102 women, 50 patients, with severe symptoms, underwent laparoscopic excision of DPE. Endoscopic surgery was performed with complete separation of the rectovaginal space and resection of the node. In the case of vaginal involvement vaginal exeresis was performed, in the case of rectal wall involvement of more than 50%, segmental bowel resection was performed. Operative data as well as dysmenorrhea, dyspareunia, chronic pelvic pain and dyschezia before and 6 and 12 months after surgical treatment were recorded. Results Mean operative time was 126.4 ± 34.7 min, mean blood loss was 76.2 ± 22 ml. In 17 (34%) cases we performed excision of the posterior vaginal fornix due to vaginal wall involvement. In six (12%) cases we performed excision of the rectal wall. At 12-month follow-up 39 (78%) women revealed absent or mild dysmenorrhea, 45 (90%) women revealed absent or mild dyspareunia, 46 (92%) women revealed absent or mild chronic pelvic pain, 48 (96%) women revealed absent or mild dyschezia. Conclusions Surgical management of DPE could be a radical approach for this disease but conservative for the patients, ensuring good improvement in symptoms and good patient satisfaction, and only performing vaginal or rectal exeresis when strictly necessary.

scholarly journals Intra- and interobserver reproducibility of pelvic ultrasound for the detection and measurement of endometriotic lesions

2020 ◽  
Vol 2020 (2) ◽  
Author(s):  
E Bean ◽  
P Chaggar ◽  
N Thanatsis ◽  
W Dooley ◽  
C Bottomley ◽  
...  
Keyword(s):  
Transvaginal Ultrasound ◽  
Separate Analysis ◽  
Pelvic Endometriosis ◽  
Pelvic Ultrasound ◽  
First Line ◽  
Deep Endometriosis ◽  
Nodule Size ◽  
Good Level ◽  
Intraobserver Reproducibility ◽  
Level Of Agreement

Abstract STUDY QUESTION What is the interobserver and intraobserver reproducibility of pelvic ultrasound for the detection of endometriotic lesions? SUMMARY ANSWER Pelvic ultrasound is highly reproducible for the detection of pelvic endometriotic lesions. WHAT IS KNOWN ALREADY Transvaginal ultrasound (TVS) has been widely adopted as the first-line assessment for the diagnosis and assessment of pelvic endometriosis. Severity of endometriosis as assessed by ultrasound has been shown to have good concordance with laparoscopy (kappa 0.79). The reproducibility of TVS for assessment of ovarian mobility and pouch of Douglas obliteration using the ‘sliding sign’ has already been described in the literature. However, there is no available data in the literature to demonstrate the intraobserver repeatability of measurements for endometriotic cysts and nodules. STUDY DESIGN, SIZE, DURATION This was a prospective observational cross-sectional study conducted over a period of 12 months. We included 50 consecutive women who were all examined by two operators (A and B) during their clinic attendance. PARTICIPANTS/MATERIALS, SETTING, METHODS The study was carried out in a specialist endometriosis centre. We included all consecutive women who had ultrasound scans performed independently by two experienced operators during the same visit to the clinic. The outcomes of interest were the inter- and intraobserver reproducibility for the detection of endometriotic lesions. We also assessed repeatability of the measurements of lesion size. MAIN RESULTS AND THE ROLE OF CHANCE There was a good level of agreement between operator A and operator B in detecting the presence of pelvic endometriotic lesions (k = 0.72). There was a very good level of agreement between operators in identifying endometriotic cysts (k = 0.88) and a good level of agreement in identifying endometriotic nodules (k = 0.61). The inter- and intraobserver repeatability of measuring endometriotic cysts was excellent (intra-class correlation (ICC) ≥ 0.98). There was good interobserver measurement repeatability for bowel nodules (ICC 0.88), but the results for nodules in the posterior compartment were poor (ICC 0.41). The intraobserver repeatability for nodule size measurements was good for both operators (ICC ≥0.86). LIMITATIONS, REASONS FOR CAUTION Within this cohort, there was insufficient data to perform a separate analysis for nodule size in the anterior compartment. All examinations were performed within a specialised unit with a high prevalence of deep endometriosis. Our findings may not apply to operators without intensive ultrasound training in the diagnosis of pelvic endometriosis. WIDER IMPLICATIONS OF THE FINDINGS These findings are important because ultrasound has been widely accepted as the first-line investigation for the diagnosis of pelvic endometriosis, which often determines the need for future investigations and treatment. The detection and measurement of bowel nodules is essential for anticipation of surgical risk and planning surgical excision. STUDY FUNDING/COMPETING INTEREST(S) The authors have no conflict of interest. No funding was obtained for this work.

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