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Differential diagnosis of middle compartment pelvic organ prolapse with transperineal ultrasound.
García-Mejido, José Antonio; Ramos-Vega, Zenaida; Armijo-Sánchez, Alberto; Fernández-Palacín, Ana; García-Jimenez, Rocío; Sainz, José Antonio.
Afiliación
  • García-Mejido JA; Department of Obstetrics and Gynecology, Valme University Hospital, Seville, Spain. jagmejido@hotmail.com.
  • Ramos-Vega Z; Department of Obstetrics and Gynecology, University of Seville, Seville, Spain. jagmejido@hotmail.com.
  • Armijo-Sánchez A; Department of Obstetrics and Gynecology, Nuestra Señora de la Merced Hospital, Seville, Spain.
  • Fernández-Palacín A; Department of Obstetrics and Gynecology, Valme University Hospital, Seville, Spain.
  • García-Jimenez R; Biostatistics Unit, Department of Preventive Medicine and Public Health, University of Seville, Seville, Spain.
  • Sainz JA; Department of Obstetrics and Gynecology, Valme University Hospital, Seville, Spain.
Int Urogynecol J ; 32(8): 2219-2225, 2021 Aug.
Article en En | MEDLINE | ID: mdl-33484288
INTRODUCTION AND HYPOTHESIS: The objective was to identify the best parameter (pubis-cervix measurement, pubis-uterine fundus measurement or pubis-pouch of Douglas measurement) on transperineal ultrasound, based on the difference between measurements taken at rest and with the Valsalva maneuver, for presurgical differential diagnosis between uterine prolapse (UP) and cervical elongation (CE) without UP. METHODS: A prospective observational study of 60 consecutively recruited patients who underwent corrective surgery of the middle compartment (UP or CE without UP). A transperineal ultrasound was performed, and the descent of the pelvic organ was measured in relation to the posteroinferior margin of the pubis in the midsagittal plane, referencing the uterine fundus, pouch of Douglas and the cervix at rest and with the Valsalva test. RESULTS: Receiver operating characteristic (ROC) curves were constructed for the three evaluated measures, based on the difference between rest and Valsalva, for the diagnosis of UP. For the pubis-cervix distance, an area under the curve (AUC) of 0.59 was obtained; for the pubis-uterine fundus distance, the AUC was 0.81; and for the pubis-pouch of Douglas distance, the AUC was 0.69. Based on the best AUC (the difference in the pubis-uterine fundus distance at rest and with the Valsalva maneuver), a cut-off point of 15 mm was established for the diagnosis of UP (sensitivity: 75%; specificity: 95%; positive predictive value: 86%; and negative predictive value: 89%). CONCLUSION: A difference of ≥15 mm in the pubis-uterine fundus distance at rest and with the Valsalva maneuver is useful for differentiating UP from CE without UP by ultrasound.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Prolapso Uterino / Prolapso de Órgano Pélvico Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans Idioma: En Revista: Int Urogynecol J Asunto de la revista: GINECOLOGIA / UROLOGIA Año: 2021 Tipo del documento: Article País de afiliación: España Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Prolapso Uterino / Prolapso de Órgano Pélvico Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans Idioma: En Revista: Int Urogynecol J Asunto de la revista: GINECOLOGIA / UROLOGIA Año: 2021 Tipo del documento: Article País de afiliación: España Pais de publicación: Reino Unido