Utility of preoperative examination and magnetic resonance  imaging for diagnosis of anterior vaginal wall masses.
OBJECTIVE
The clinical evaluation of anterior vaginal wall masses can present a dilemma, as there are no well-defined pathways for diagnosis and management. Our objective was to evaluate the role and accuracy of preoperative exam and magnetic resonance imaging (MRI) for these masses.


METHODS
We identified women with a mass using billing codes for 10 years. We compared data from the preoperative evaluation to postoperative pathology if available.


RESULTS
Analysis after chart review on 47 women was performed. Of the 34 women who had surgery, 28 (82.4%) also underwent an MRI. MRI diagnosis was accurate in 22/28 women compared to histology, inconclusive in 4, and inaccurate in 2. Preoperative diagnosis, including exam, MRI, and cystourethroscopy, had a diagnostic accuracy of 94.1% compared to postoperative diagnosis. The positive predictive value of MRI alone was 91.7%.


CONCLUSIONS
Preoperative diagnosis using exam, MRI, and cystourethroscopy have a high diagnostic accuracy for anterior vaginal wall masses.
Department of Obstetrics and Gynecology, Division of Urogynecology, New York Presbyterian Hospital/Weill Cornell Medical Center, 525 East 68th Street, J-130, New York, NY 10065, USA. tirsit@yahoo.com
Tirsit S
TS
Asfaw
Joy A
JA
Greer
Parvati
P
Ramchandani
Megan O
MO
Schimpf
D000293:Adolescent; D000328:Adult; D000368:Aged; D003951:Diagnostic Errors / Q000517:prevention & control; D005260:Female; D013509:Gynecologic Surgical Procedures; D058869:Gynecological Examination / Q000379:methods*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D011184:Postoperative Period; D011300:Preoperative Care / Q000379:methods*; D012189:Retrospective Studies; D014521:Urethra / Q000473:pathology; D014621:Vagina / Q000473:pathology*; D014623:Vaginal Diseases / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D055815:Young Adult