التفاصيل البيبلوغرافية
| العنوان: |
Preoperative diagnosis of ureteral medial deviations secondary to deep endometriosis using transvaginal ultrasound examinations: Can we predict the need for ureterolysis during laparoscopic surgery? |
| المؤلفون: |
Carfagna, Pietro, De Cicco Nardone, Alessandra, Benvenga, Greta, Nardone, Fiorenzo De Cicco, Greco, Pierfrancesco, Campolo, Federica, Pafundi, Pia Clara, Alesi, Maria Vittoria, Testa, Antonia Carla, Scambia, Giovanni, Ianieri, Manuel Maria |
| المصدر: |
International Journal of Gynecology & Obstetrics ; ISSN 0020-7292 1879-3479 |
| بيانات النشر: |
Wiley |
| سنة النشر: |
2024 |
| المجموعة: |
Wiley Online Library (Open Access Articles via Crossref) |
| الوصف: |
Objective To evaluate ureteral involvement using transvaginal sonography (TVS) regarding the distortion of the course of the ureters caused by deep endometriosis (DE), which can facilitate predicting the need for ureterolysis during surgery, even in the absence of ureteral stenosis or dilatation. Methods This is a single‐center, observational, retrospective pilot study of 88 consecutive patients who later underwent surgery for DE that used ultrasound preoperative diagnosis of ureteral medial deviation of one or both ureters between January 2019 and January 2022. At TVS, the course of the ureter was considered medialized if, in longitudinal and transversal section, any distance was detectable between the ureter and the cervix at the point where the ureter crosses the uterine artery. The primary end point was to determine sensitivity, specificity, and positive and negative predictive values of “ureteral medial deviation” diagnosed using TVS, in order to predict the need for ureterolysis. Results Our series included 88 women with a median age of 39 (interquartile range 33–43) years. Ureteral medialization showed a relatively low false‐positive rate (10.9%), with a specificity of 89.1% (95% confidence interval [CI] 81.4%–96.7%) and a sensitivity of 86.6% (95% CI 80.3%–92.9%), along with a high positive predictive value of 93.3% (95% CI 88.4%–98.1%), and a lower negative predictive value of 79.1% (95% CI 69.8%–88.5%), respectively. Conclusions This study introduced a new ultrasound sign with a high degree of accuracy to predict ureterolysis and this may have positive implications in the management and surgical planning of patients with ureteral endometriosis. |
| نوع الوثيقة: |
article in journal/newspaper |
| اللغة: |
English |
| DOI: |
10.1002/ijgo.15434 |
| الإتاحة: |
https://doi.org/10.1002/ijgo.15434Test |
| حقوق: |
http://onlinelibrary.wiley.com/termsAndConditions#vorTest |
| رقم الانضمام: |
edsbas.9C734F8B |
| قاعدة البيانات: |
BASE |
