title: The accuracy of examination under anesthesia and transvaginal sonography in evaluating ovarian size.
abstract: OBJECTIVE
  To compare pelvic examination under anesthesia to transvaginal sonography (TVS) as a method for ovarian detection and measurement.
  
  
  METHODS
  Two hundred and eighty-nine ovaries from 151 women were evaluated. After induction of anesthesia, a complete pelvic examination and TVS were performed, and the ovaries were removed surgically. Ovarian dimensions generated sonographically and estimated on clinical examination were compared to those obtained from the measured surgical specimen.
  
  
  RESULTS
  Forty-four percent of ovaries were palpable clinically whereas 85% were visualized sonographically (P < 0.001). Right ovaries were palpable more frequently than left ovaries (P < 0.01). Ovaries were detected clinically in 30% of women > or = 55 years of age versus 51% of women <55 years of age (P < 0.05), in 9% of women weighing > or = 200 lb versus 55% of women weighing <200 lb (P < 0.001), and in 12% of women with a uterine weight > or = 200 g versus 51% of women with a uterine weight <200 g (P < 0.001). TVS was significantly more accurate than clinical examination in detecting ovaries in women with these high risk characteristics.
  
  
  CONCLUSIONS
  TVS is significantly more accurate than clinical examination in detecting ovaries and in defining their dimensions. Ovaries frequently are not palpable in women > or = 55 years of age, women who weigh > or = 200 lb, or women with an enlarged uterus (> 200 g). The addition of TVS to annual pelvic examination may be beneficial in women > or = 55 years of age who are overweight and therefore at high risk to develop ovarian cancer.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky Medical Center-Markey Cancer Center, 800 Rose Street, Lexington, KY 40536-0293, USA. arwils1@email.uky.edu
authors.forename: Fred R
authors.initials: FR
authors.lastname: Ueland
authors.forename: Paul D
authors.initials: PD
authors.lastname: Depriest
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Desimone
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Pavlik
authors.forename: Subodh M
authors.initials: SM
authors.lastname: Lele
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Kryscio
authors.forename: J R
authors.initials: JR
authors.lastname: van Nagell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General; D005260:Female; D006801:Humans; D008875:Middle Aged; D009929:Organ Size; D010053:Ovary / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D010173:Palpation; D010388:Pelvis; D010808:Physical Examination; D011446:Prospective Studies; D014463:Ultrasonography / Q000379:methods; D014621:Vagina