A M Darwish1, A F Amin, M A El-Feky. 1. Department of Obstetrics and Gynecology, Assiut University Hospital, Assiut, Egypt.
Abstract
STUDY OBJECTIVE: To test the value of ovarioscopy as an additional step in the diagnostic work-up of probably benign cystic ovarian tumors before laparoscopic intervention, and to compare its diagnostic accuracy with that of transvaginal ultrasonography (TVUS) and tumor markers. DESIGN: Cross-sectional study (Canadian Task Force classification II-2). SETTING: Gynecologic endoscopy unit at a university hospital. PATIENTS: Sixty-eight women with unilateral or bilateral ovarian cystic swellings without clinical, sonographic, or laparoscopic suspicion of malignancy. INTERVENTION: Preoperatively, TVUS and tumor markers were estimated. Intraoperative endocystic ovarioscopic visualization ovarioscopy and ovarioscopy-guided biopsy were done before laparoscopy. MEASUREMENTS AND MAIN RESULTS: Ovarioscopy had the highest specificity for detecting benign ovarian cysts (98%) compared with (72.6%) and (72%) for tumor markers and TVUS, respectively. Its positive predictive value was 50% compared with 5% and 6% for tumor markers and TVUS, respectively. Its findings agreed with the histopathologic diagnosis in 39 patients (57%, p = 0.000, k = 0.85). CONCLUSION: Ovarioscopy is a simple, rapid maneuver that should precede laparoscopic ovarian cystectomy. It is superior to tumor markers and TVUS for predicting the benign nature of ovarian cysts.
STUDY OBJECTIVE: To test the value of ovarioscopy as an additional step in the diagnostic work-up of probably benign cystic ovarian tumors before laparoscopic intervention, and to compare its diagnostic accuracy with that of transvaginal ultrasonography (TVUS) and tumor markers. DESIGN: Cross-sectional study (Canadian Task Force classification II-2). SETTING: Gynecologic endoscopy unit at a university hospital. PATIENTS: Sixty-eight women with unilateral or bilateral ovarian cystic swellings without clinical, sonographic, or laparoscopic suspicion of malignancy. INTERVENTION: Preoperatively, TVUS and tumor markers were estimated. Intraoperative endocystic ovarioscopic visualization ovarioscopy and ovarioscopy-guided biopsy were done before laparoscopy. MEASUREMENTS AND MAIN RESULTS: Ovarioscopy had the highest specificity for detecting benign ovarian cysts (98%) compared with (72.6%) and (72%) for tumor markers and TVUS, respectively. Its positive predictive value was 50% compared with 5% and 6% for tumor markers and TVUS, respectively. Its findings agreed with the histopathologic diagnosis in 39 patients (57%, p = 0.000, k = 0.85). CONCLUSION: Ovarioscopy is a simple, rapid maneuver that should precede laparoscopic ovarian cystectomy. It is superior to tumor markers and TVUS for predicting the benign nature of ovarian cysts.