title: Investigation of anogenital distance as a diagnostic tool in endometriosis.
abstract: An association between anogenital distance (AGD) and endometriosis has been reported, suggesting that AGD may be a useful clinical tool in endometriosis. The predictive ability of AGD of women in discriminating presence and type of endometriosis was examined. A case-control study was conducted at the University Hospital 'Virgen de la Arrixaca', Murcia, Spain, between 2014 and 2015. A total of 114 participants diagnosed with endometriosis using ultrasound findings and 105 controls were recruited. Two AGD measurements were obtained: one from the anterior clitoral surface to the upper verge of the anus (AGDAC), and another one from the posterior fourchette to the upper verge of the anus (AGDAF). Parametric and non-parametric tests andreceiver operator characterstic analyses were used to determine relationships between AGD and presence of endometriosis and subgroups (ovarian endometriomas or deep infiltrating endometriosis [DIE]). The AGDAF, but not AGDAC, was associated with presence of endometriomas, DIE (P-values, <0.001-0.02), or both. The highest area under curve (0.91; 95% CI 0.84 to 0.97) was obtained for the DIE subgroup with the AGDAFmeasurement, with a sensitivity and specificity of 84.4% and 91.4%, respectively. AGDAFcan therefore efficiently discriminate the presence of DIE and may be a useful clinical tool.
authors.affiliation: Department of Obstetrics and Gynecology, 'Virgen de la Arrixaca' University Clinical Hospital, 30120 El Palmar, Murcia, Spain; Institute for Biomedical Research of Murcia, IMIB-Arrixaca, 30120 El Palmar, Murcia, Spain.
authors.forename: Maria L
authors.initials: ML
authors.lastname: Sánchez-Ferrer
authors.affiliation: Division of Preventive Medicine and Public Health, Department of Public Health Sciences, University of Murcia School of Medicine, 30100 El Palmar, Murcia, Spain; Institute for Biomedical Research of Murcia, IMIB-Arrixaca, 30120 El Palmar, Murcia, Spain. Electronic address: jaime.mendiola@um.es.
authors.forename: Jaime
authors.initials: J
authors.lastname: Mendiola
authors.affiliation: Department of Obstetrics and Gynecology, 'Virgen de la Arrixaca' University Clinical Hospital, 30120 El Palmar, Murcia, Spain.
authors.forename: Raquel
authors.initials: R
authors.lastname: Jiménez-Velázquez
authors.affiliation: Department of Obstetrics and Gynecology, 'Virgen de la Arrixaca' University Clinical Hospital, 30120 El Palmar, Murcia, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Cánovas-López
authors.affiliation: Department of Obstetrics and Gynecology, 'Virgen de la Arrixaca' University Clinical Hospital, 30120 El Palmar, Murcia, Spain.
authors.forename: Shiana
authors.initials: S
authors.lastname: Corbalán-Biyang
authors.affiliation: Department of Obstetrics and Gynecology, 'Virgen de la Arrixaca' University Clinical Hospital, 30120 El Palmar, Murcia, Spain.
authors.forename: Ana I
authors.initials: AI
authors.lastname: Hernández-Peñalver
authors.affiliation: Department of Obstetrics and Gynecology, 'Virgen de la Arrixaca' University Clinical Hospital, 30120 El Palmar, Murcia, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Carmona-Barnosi
authors.affiliation: Division of Preventive Medicine and Public Health, Department of Public Health Sciences, University of Murcia School of Medicine, 30100 El Palmar, Murcia, Spain; Department of Preventive Medicine, 'Reina Sofia' University General Hospital, 30003 Murcia, Murcia, Spain.
authors.forename: Ana B
authors.initials: AB
authors.lastname: Maldonado-Cárceles
authors.affiliation: Department of Obstetrics and Gynecology, 'Virgen de la Arrixaca' University Clinical Hospital, 30120 El Palmar, Murcia, Spain; Institute for Biomedical Research of Murcia, IMIB-Arrixaca, 30120 El Palmar, Murcia, Spain.
authors.forename: Maria T
authors.initials: MT
authors.lastname: Prieto-Sánchez
authors.affiliation: Department of Obstetrics and Gynecology, 'Virgen de la Arrixaca' University Clinical Hospital, 30120 El Palmar, Murcia, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Machado-Linde
authors.affiliation: Department of Obstetrics and Gynecology, 'Virgen de la Arrixaca' University Clinical Hospital, 30120 El Palmar, Murcia, Spain; Institute for Biomedical Research of Murcia, IMIB-Arrixaca, 30120 El Palmar, Murcia, Spain.
authors.forename: Anibal
authors.initials: A
authors.lastname: Nieto
authors.affiliation: Division of Preventive Medicine and Public Health, Department of Public Health Sciences, University of Murcia School of Medicine, 30100 El Palmar, Murcia, Spain; Institute for Biomedical Research of Murcia, IMIB-Arrixaca, 30120 El Palmar, Murcia, Spain; Department of Preventive Medicine, 'Reina Sofia' University General Hospital, 30003 Murcia, Murcia, Spain; Biomedical Research Centre Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain.
authors.forename: Alberto M
authors.initials: AM
authors.lastname: Torres-Cantero
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000033:anatomy & histology*; D016022:Case-Control Studies; D004715:Endometriosis / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D005836:Genitalia, Female / Q000033:anatomy & histology*; D006801:Humans; D011237:Predictive Value of Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013030:Spain
keywords: Anogenital distance; Endometriosis; ROC curve