Role of ultrasonographic parameters for predicting tubal involvement in infertile patients affected by endometriosis: A retrospective cohort study

Anna Katarzyna Stepniewska, Anna Stepniewska, Clarizia R, Roberto Clarizia, De Mitri P, Paola De Mitri, Pesci A, Anna Pesci, Zorzi C, Carlotta Zorzi, Albanese M, Mara Albanese, Giamberto Trivella, Trivella G, Massimo Guerriero, Guerriero M, Improda FP, Francesco Paolo Improda, Marcello Ceccaroni, Ceccaroni M
Journal of gynecology obstetrics and human reproduction · 2021 · vol. 50(10) , pp. 102208 · doi:10.1016/j.jogoh.2021.102208 · PMID:34418594 · W3194800405
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This retrospective cohort study investigated how ultrasonographic parameters predict tubal involvement in infertile patients with endometriosis.

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Abstract

IntroductionTransvaginal ultrasound is fundamental for the mapping of endometriosis, and the imaging criteria have been clearly described for different organs study. However, no specific ultrasonographic signs of tubal endometriosis have been reported, with the exception of hydrosalpinx, which is the expression of an extreme tubal damage and obstruction. The detection of tubal pathology in infertile patients is fundamental, therefore the aim of the study was to evaluate incidence of tubal endometriosis in infertile patients, and to analyze ultrasonographic signs useful for detection of this condition.Material and methodsIt is a single-center, retrospective cohort study. All 500 consecutive infertile women who underwent laparoscopic surgery for endometriosis were included. The preoperative workup included transvaginal ultrasound and was compared to intraoperative findings and histologic study.ResultsThe incidence of tubal endometriosis in our study was 8%. Using hydrosalpinx as the ultrasonographic marker for tubal involvement the overall pooled, sensitivity and specificity of TVU were 12% (95%CI, 5-23%) and 99% (95%CI, 98-100%), respectively. If at least one ultrasonographic parameter like hydrosalpinx, periadnexal adhesions or ovarian cyst was considered as a sign of tubal endometriosis, a sensitivity, VPN and specificity were 94% (95% IC, 85-98%), 97% (95%IC, 93-99%) and 31% (95%CI, 27-36%), respectively.DiscussionHydrosalpinx as ultrasonographic sign alone is characterized by a high specificity but low sensitivity for detection of tubal endometriosis; its sensitivity can be improved by the addition of other markers such as endometrioma and/or periadnexal adhesions.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Fallopian Tube Diseases Fallopian Tube Diseases Ultrasonography Adult Cohort Studies Endometriosis Endometriosis Fallopian Tube Diseases Fallopian Tube Diseases Fallopian Tubes Fallopian Tubes Female Humans Infertility, Female Infertility, Female Infertility, Female Italy Italy Retrospective Studies

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