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

Paul J. Yong, P J Yong, Chris Sutton, C Sutton, Sutton C, M. Suen, Michael W.H. Suen, C Williams, Christina Williams, Williams C
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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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 Adult Chronic Pain Chronic Pain Chronic Pain Chronic Pain Endometriosis Endometriosis Endometriosis Female Female Gynecological Examination Gynecological Examination Humans Humans Infertility, Female

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (12)

Cited by (31)

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