Chronic Pelvic Pain in Adolescents Transvaginal ultrasound Versus Laparoscopy A Prospective Cross Sectional Observational Study
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Author(s)
Abstract
Background: Chronic pelvic pain (CPP) is cyclic or noncyclic, intermittent or constant discomfort in the pelvic region for at least 6 months. It is a common complaint in female adolescents that may be overlooked.Objective: To evaluate CPP in adolescents using transvaginal ultrasound (TVS) and laparoscopy.Study design: This is a prospective cross sectional observational study conducted at gynecology clinic of Al Azhar University Hospital of Assiut- Egypt. A total of 100 adolescents with CPP were evaluated by TVS and laparoscopy and findings were analyzed. Results: The mean age of adolescents was 17 ± 3.5 the majority were parous (51%), rural (69%) and low social class (65 %(. Diffuse pelvic pain was present in (62%), Dysmenorrhea in (61%), deep abdominal and pelvic tenderness in (55% and 80% respectively). TVS was normal in (40%) and abnormal in (60%). Laparoscopic evaluation was normal in (29%) and abnormal in (71%) in the form of tubo- ovarian masses (19%), endometriosis (18%) ovarian cysts (9%), adenomyosis (8%), Adhesions (6%), PID and RVF uterus (4% for each), subserous fibroid and pelvic congestion (1% for each). sensitivity and specificity of TVS were (81.7% and 93.1% respectively). Positive and negative predictive values were 96.7% and 67.5% respectively. Kappa test between TVS and laparoscopy showed good agreement (kappa = 0.67(.Conclusions: Good agreement was found between TVS and laparoscopy, however, laparoscopy is considered as a gold standard tool in evaluating adolescent CPP because of distinct advantages in terms of sensitivity and negative predictive value.
Keywords
Chronic Pelvic Pain, TVS, Laparoscopy, adolescents
Cite this paper
Mahmoud Edessy, Abdel Aziz G. El Darwish, Ahmed Ali M. Nasr, Manal G. Abd El Aty, Mahmoud I. El Rashedy, Hosam H. El Katatny, Fawzya M.,
Chronic Pelvic Pain in Adolescents Transvaginal ultrasound Versus Laparoscopy A Prospective Cross Sectional Observational Study
, SCIREA Journal of Clinical Medicine.
Volume 1, Issue 1, October 2016 | PP. 86-96.
References
[ 1 ] | Vercellini, P., Somigliana, E., Viganò, P., Abbiati, A., Barbara, G., & Fedele, L.. Chronic pelvic pain in women: etiology, pathogenesis and diagnostic approach. Gynecological Endocrinology, (2009); 25(3), 149-158. |
[ 2 ] | Hebbar S, Chawla C. Role of Laparoscopy in evaluation of chronic pelvic pain. J Minimal Access Surg 2005; 1(3): 116-20. |
[ 3 ] | Demir F, Ozcimen EE and Oral HB The role of gynecological, urological, and psychiatric factors in chronic pelvic pain. Archive Gynecology and Obstetrics (2012); 286(5) 1215-1220. |
[ 4 ] | Hewitt, Geri D., and Robert T. Brown. "Chronic Pelvic Pain in the Adolescent Differential Diagnosis and Evaluation." FEMALE PATIENT-TOTAL HEALTH CARE FOR WOMEN HEALTH CARE PROVIDER EDITION- 25.1 (2000): 38-48. |
[ 5 ] | Song AH, Advincula AP. Adolescent chronic pelvic pain. J Pediatric and Adolescent Gynecology. 2005; 18 (6) : 371-377. |
[ 6 ] | Kamilya Gourisankar, Mukherji Joydev, Gayen Abhimanyu: Different methods for evaluation of chronic pelvic pain. J Obstet Gynecol India Vol. 55, No. 3 : May/June 2005 Pg 251-253 |
[ 7 ] | Seema Sharma and Ashok Kumar Meena: LAPAROSCOPIC ASSESSMENT OF CHRONIC PELVIC PAIN IN WOMEN – SEE AND FIGHT POLICY. CIBTech Journal of Surgery ISSN: 2319-3875, 2013 Vol. 2 (1), pp.38-44. |
[ 8 ] | Yong PJ, Sutton C, Suen M, Williams C. Endovaginal ultrasound-assisted pain mapping in endometriosis and chronic pelvic pain. Journal of obstetrics and gynecology 2013;33(7):715-9. |
[ 9 ] | Rather, Shugufta Y., et al. "A Comparative Study of Transvaginal Sonography versus Laparoscopy Evaluation in Chronic Pelvic Pain: Original Study." International Journal of Clinical and Experimental Medical Sciences 1.1 (2015): 4-6. |
[ 10 ] | Zubor P, Szunyogh N, Galo S, Biringer K, Docus A and Visnovsky J. Laparoscopy in chronic pelvic pain – a prospective clinical study. Journal of Ceska Gynecology (2005) ;70(3) 225-231. |
[ 11 ] | Kang SB, Chung HH, Lee HP, Lee JW, and Chang YS. Impact of diagnostic laparoscopy on the management of chronic pelvic pain. Surgical Endoscopy 2007;21(6):916-9. |
[ 12 ] | Sharma D, Dahiya K and Duhan N et al. (2011). Diagnostic laparoscopy in chronic pelvic pain. Archive Gynecology and Obstetrics 28 |
[ 13 ] | Okaro E, Condous G, Khalid A, Timmerman D, Ameye L, Huffel SV et al. The use of ultrasoundbased 'soft markers' for the prediction of pelvic pathology in women with chronic pelvic pain BJOG 2006;113(3):251-256. |