Cited by 183Endometriosis Research and TreatmentGynecological conditions and treatmentsEctopic Pregnancy Diagnosis and Management

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Diagnosis of deep endometriosis by clinical examination during menstruation and plasma CA-125 concentration

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Koninckx, Philippe R., Meuleman, Christel, Oosterlynck, Didier, Cornillie, Freddy J.·1996·Fertility and Sterility

DOI 10.1016/s0015-0282(16)58086-8

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Abstract

Objectives To evaluate a clinical examination during menstruation and plasma CA-125 concentrations to diagnose deep endometriosis.Design Prospective study in 61 women scheduled for a laparoscopy, a retrospective study in 140 women with deep endometriosis, and a clinical validation study in 16 women with painful pelvic nodularities during menstruation.Setting University Hospital Gasthuisberg, a tertiary referral center.Results In the retrospective study, deep endometriosis was detected by routine clinical examination in only 36% of women. Lesions infiltrating deeper than 15 mm were detected in 50%. In the prospective study pelvic nodularities were detected by routine clinical examination in 4 women but were detected in 22 by clinical examination during menstruation. The latter was highly reliable to diagnose deep endometriosis, cystic ovarian endometriosis, and cul-de-sac obliteration. CA-125 concentrations were higher during menstruation and correlated with deep endometriosis and with deep and cystic ovarian endometriosis. Nodularities at clinical examination or follicular phase CA-125 concentrations > 35 U/mL are useful to decide that a bowel preparation should be given, achieving a sensitivity of 87% and a specificity of 83%. In the clinical validation study, deep endometriosis was found in 14 of 16 women.Conclusion Clinical examination during menstruation can diagnose reliably deep endometriosis, cystic ovarian endometriosis, or cul-de-sac adhesions. This test, preferentially combined with a follicular phase CA-125 assay, should be used to decide whether a preparation for bowel surgery should be given.

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Authors: Koninckx, P. R., Meuleman, C., Oosterlynck, D., & Cornillie, F. J.
Affiliations: Universitair Ziekenhuis Leuven (BE)
ORCID: Meuleman, Christel
Venue: Fertility and Sterility
Publisher: Elsevier BV
Published: 1996-02
Volume: 65
Issue: 2
Pages: 280-287
ISSN: 0015-0282 (ISSN-L)
DOI: 10.1016/s0015-0282(16)58086-8
OpenAlex: W4295691139
Cited by: 183
References: 24
Citations by year: 2026: 1 · 2025: 6 · 2024: 4 · 2023: 6 · 2022: 6 · 2021: 7 · 2020: 4 · 2019: 5 · 2018: 7 · 2017: 7 · 2016: 6 · 2015: 6 · 2014: 4 · 2013: 4 · 2012: 10
FWCI: 3.83
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 9612 d)
Locations: Fertility and Sterility (publishedVersion)
PubMed (publishedVersion)
PubMed
Topics: Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
Health Sciences › Medicine › Obstetrics and Gynecology › Ectopic Pregnancy Diagnosis and Management
Keywords: deep infiltrating endometriosis, CA125, bowel preparation, sensitivity and specificity
MeSH terms: Endometriosis, Female, Humans, Menstruation, Prospective Studies, Retrospective Studies, Sensitivity and Specificity, CA-125 Antigen

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Diagnosis of deep endometriosis by clinical examination during menstruation and plasma CA-125 concentration

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