Endovaginal ultrasound-assisted pain mapping in endometriosis and chronic pelvic pain

P J Yong, Paul J. Yong, Chris Sutton, C Sutton, Michael W.H. Suen, M Suen, C Williams, Christina Williams
Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology · 2013 · vol. 33(7) , pp. 715–719 · doi:10.3109/01443615.2013.821971 · PMID:24127962 · W2108801025
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Endovaginal ultrasound-assisted pain mapping demonstrated higher sensitivity than digital pelvic exam alone for predicting abnormal laparoscopic findings in chronic pelvic pain patients without nodules or endometriomas.

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Abstract

The objective of this study was to determine if the combination of tenderness-guided endovaginal ultrasound and digital pelvic exam (i.e. EVUS-assisted exam) for preoperative pain mapping, in cases without nodules or endometriomas, increases sensitivity/specificity for laparoscopic findings. This was a retrospective review of women with chronic pelvic pain ± infertility with preoperative pain mapping exam prior to laparoscopy (n = 97, 2006-7). Predictor variables (EVUS-assisted exam vs digital pelvic exam alone, for pain mapping) were coded as tender vs non-tender. Primary outcome was findings on laparoscopy (e.g. endometriosis or adhesions) and was coded as abnormal vs normal. We found that EVUS-assisted exam had greater sensitivity (0.81, 95% CI: 0.70-0.89) for abnormal laparoscopy compared with digital pelvic exam alone (0.58, 95% CI: 0.46-0.69) (McNemar's test, p < 0.001). Specificity was limited for both types of pain mapping (0.22, 95% CI: 0.08-0.44 for EVUS-assisted; and 0.39, 95% CI: 0.20-0.61 for digital), with no significant difference (p = 0.13). In conclusion, in the absence of nodules or endometriomas, EVUS-assisted exam increases sensitivity, but with no benefit in specificity, for prediction of abnormal laparoscopy.

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Condition tags

endometriosischronic_pelvic_paininfertility

MeSH descriptors

Endometriosis Gynecological Examination Infertility, Female Pelvic Pain Adult Chronic Pain Chronic Pain Chronic Pain Endometriosis Endometriosis Female Gynecological Examination Humans Infertility, Female Infertility, Female Laparoscopy Pelvic Pain Pelvic Pain Preoperative Care Retrospective Studies

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Cited by (32)

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