Chronic Pelvic Pain in Adolescents Transvaginal ultrasound Versus Laparoscopy, A Prospective Cross Sectional Observational Study
Journal Title: INTERNATIONAL JOURNAL OF CURRENT RESEARCH IN MEDICAL SCIENCES - Year 2016, Vol 2, Issue 10
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%), Dysmenorrheain (61%), deep abdominal and pelvic tenderness in (55% and 80% respectively). TVS was normal in (40%) andabnormalin (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.
Authors and Affiliations
Mahmoud Edessy, Abdel Aziz G. El Darwish, Ahmed Ali M. Nasr* , Manal G. Abd El Aty, Mahmoud I. El Rashedy, Hosam H. El Katatny and Fawzya M.
Keywords
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