Prediction of pouch of Douglas obliteration in women with suspected endometriosis using a new real-time dynamic transvaginal ultrasound technique: the sliding sign

• DOI: 10.1002/uog.12305
• Publication Date: 2012-09-24T08:57:10Z
• Authors: S. Reid; C. Lu; I. Casikar; G. Reid; J. Abbott; G. Cario; D. Chou; D. Kowalski; M. Cooper; G. Condous
• Keywords: Pouch; Transvaginal sonography

Objective To evaluate preoperative real-time dynamic transvaginal sonography (TVS) in the prediction of pouch Douglas (POD) obliteration women undergoing laparoscopy for suspected endometriosis. METHODS This was a multicenter prospective observational study undertaken from January 2009 to November 2011. All with symptoms suggestive endometriosis who were scheduled underwent detailed TVS, particular ascertain whether POD obliterated. assessed using TVS technique called ‘sliding sign’. Preoperative sliding sign findings then compared gold standard laparoscopic findings. Results One hundred consecutive and outcomes included final analysis. Mean age 32.8 years mean at diagnosis 27.4 years. At laparoscopy, 84/100 (84%) found have some form (73% peritoneal endometriosis, 35% ovarian endometrioma(s), 33% deep infiltrating endometriosis). 30/100 (30%) had an obliterated 19/30 (63.3%) these also evidence bowel The sonographic accuracy 93.0%, sensitivity 83.3%, specificity 97.1%, positive predictive value 92.6%, negative 93.2%, likelihood ratio 29.2 0.17 (P = 1.8E−16). Conclusions evaluation seems establish high degree certainty is Given increased risk obliteration, may be useful identification higher Copyright © 2012 ISUOG. Published by John Wiley & Sons Ltd.