Positive predictive value of clinical diagnosis of endometriosis
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This study found that severe dysmenorrhea combined with cul-de-sac or uterosacral ligament nodularity yielded a positive predictive value of 94.0% for clinically diagnosing endometriosis.
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Abstract
OBJECTIVE: To determine the positive predictive value of the combined symptoms of severe dysmenorrhea with the sign of tenderness and/or nodularity of the cul-de-sac and/or uterosacral ligament(s) in diagnosing endometriosis clinically.
MATERIAL AND METHOD: In this prospective study, 116 patients with severe dysmenorrhea, after excluding urinary and gastrointestinal disease, underwent pelvic examination by the same investigator. Women having adnexal mass on pelvic examination were excluded Tenderness, and also nodularity, of the cul-de-sac, right and left uterosacral ligament were recorded separately. The laparoscopist did not know the findings of the pelvic examination. The diagnosis of endometriosis was made visually when lesions were typical and all other lesions were biopsied.
RESULTS: The prevalence of endometriosis was 78.4%. Tenderness, nodularity, tenderness and nodularity, and also tenderness or nodularity of cul-de-sac and/or uterosacral ligament(s) were all statistically significantly associated with the presence of endometriosis (P = .048, .005, .004, and .004 respectively). The positive predictive values were 85.5%, 94.0%, 94.6% and 86.7%, respectively.
CONCLUSION: The positive predictive value of severe dysmenorrhea with nodularity of the cul-de-sac and/or uterosacral ligament(s) was 94.0%.
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Cited by (21)
- Transvaginal Ultrasound vs. Magnetic Resonance Imaging (MRI) Value in Endometriosis Diagnosis 2022
- Can We Diagnose Early Endometriosis with Ultrasound Rather than Laparoscopy? 2020
- An evidence-based approach to assessing surgical versus clinical diagnosis of symptomatic endometriosis 2018
- Prediction of Pouch of Douglas Obliteration: Point-of-care Ultrasound Versus Pelvic Examination 2018
- Endometriosis-related infertility: ovarian endometrioma per se is not associated with presentation for infertility 2016
- MRI technique for the preoperative evaluation of deep infiltrating endometriosis: current status and protocol recommendation 2015
- Prediction of endometriosis by transvaginal ultrasound in reproductive-age women with normal ovarian size 2014
- Clinical prediction of deeply infiltrating endometriosis before surgery: is it feasible? A review of the literature 2013
- Uterine sliding sign: a simple sonographic predictor for presence of deep infiltrating endometriosis of the rectum 2013
- Diagnosis, management, and long-term outcomes of rectovaginal endometriosis 2013
- History, pelvic examination findings and mobility of ovaries as a sonographic marker to detect pelvic adhesions with fixed ovaries 2013
- Accuracy of transvaginal sonography and contrast-enhanced magnetic resonance-colonography for the presurgical staging of deep infiltrating endometriosis 2012
- Clinical predictors of endometriosis in the infertility population: is there a better way to determine who needs a laparoscopy? 2012
- Rezidivierende Endometriose bei Kinderwunsch: Operieren oder stimulieren? 2012
- Endometriose profunda: aspectos ecográficos 2010
- Combination of transvaginal sonography and clinical examination for preoperative diagnosis of pelvic endometriosis 2009
- Surgery for endometriosis-associated infertility: a pragmatic approach 2008
- [Management of endometriosis: clinical and biological assessment] 2007
- [Endometriosis: good practice rules for diagnostic laparoscopy] 2007
- Determinants of long-term clinically detected recurrence rates of deep, ovarian, and pelvic endometriosis 2006
- Advances in the management of endometriosis: an update for clinicians 2005
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