title: Accuracy of preoperative real-time dynamic transvaginal ultrasound sliding sign in prediction of pelvic adhesions in women with previous abdominopelvic surgery: prospective, multicenter, double-blind study.
abstract: To investigate the role of the transvaginal sonographic (TVS) sliding sign in predicting pelvic adhesions in women with previous abdominopelvic surgery.
  
  
  
  This was a multicenter, prospective, interventional, double-blind study of patients with a history of abdominopelvic surgery who were undergoing laparoscopy or laparotomy during the 6-month period from March to August 2016 in one of three academic obstetrics and gynecology departments. Prior to surgery, patients were examined by TVS to assess the vesicouterine pouch, uterus, ovaries and pouch of Douglas, using the TVS pelvic sliding sign. Ultrasound findings and medical and surgical data were recorded. We assessed the accuracy of the preoperative TVS sliding sign in the prediction of pelvic adhesions overall and in each compartment separately.
  
  
  
  During the study period, complete TVS sliding sign and laparoscopic or laparotomic data were available for 107 women. Their mean age was 44.0 (95% CI, 41.6-46.4; range, 20-79) years. Their mean parity was 2.0 (95% CI, 1.7-2.3; range, 0-9) and the mean number of previous abdominal surgical procedures per patient was 1.3 (95% CI, 1.2-1.5; range, 1-4). Adhesions were noted in 27/107 (25.2%) patients. The TVS sliding sign had a sensitivity of 96.3% and specificity of 92.6% in predicting pelvic adhesions. There was a significant relationship between adhesions in each compartment and the TVS sliding sign (P < 0.05).
  
  
  
  The TVS sliding sign is an effective means to detect preoperatively pelvic adhesions in patients with previous abdominopelvic surgery. Use of such a non-invasive and well-tolerated technique could help in the planning of laparoscopy or laparotomy and counseling of these patients. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
authors.affiliation: Department of Obstetrics and Gynaecology, University Hospital of Bougatfa, Bizerte, Tunisia.|Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia.
authors.forename: A
authors.identifier: 0000-0002-3537-0170
authors.initials: A
authors.lastname: Ayachi
authors.affiliation: Department of Obstetrics and Gynaecology, Taher Sfar Hospital, Mahdia, Tunisia.
authors.forename: R
authors.initials: R
authors.lastname: Bouchahda
authors.affiliation: Department of Obstetrics and Gynaecology, University Hospital of Bougatfa, Bizerte, Tunisia.|Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia.
authors.forename: S
authors.initials: S
authors.lastname: Derouich
authors.affiliation: Department of Obstetrics and Gynaecology, University Hospital of Bougatfa, Bizerte, Tunisia.|Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia.
authors.forename: L
authors.initials: L
authors.lastname: Mkaouer
authors.affiliation: Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia.|Department of Obstetrics and Gynaecology, Neonatology and Maternity Center of Tunis, Tunis, Tunisia.
authors.forename: M
authors.initials: M
authors.lastname: Kehila
authors.affiliation: Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia.|Department of Obstetrics and Gynaecology, Neonatology and Maternity Center of Tunis, Tunis, Tunisia.
authors.forename: H
authors.initials: H
authors.lastname: Abouda
authors.affiliation: Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia.|Department of Obstetrics and Gynaecology, Neonatology and Maternity Center of Tunis, Tunis, Tunisia.
authors.forename: B
authors.initials: B
authors.lastname: Channoufi
authors.affiliation: Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia.|Department of Obstetrics and Gynaecology, Aziza Othmana Hospital, Tunis, Tunisia.
authors.forename: M
authors.initials: M
authors.lastname: Bouyahia
authors.affiliation: Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia.|Department of Obstetrics and Gynaecology, Aziza Othmana Hospital, Tunis, Tunisia.
authors.forename: M
authors.initials: M
authors.lastname: Braham
authors.affiliation: Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia.|Department of Obstetrics and Gynaecology, Aziza Othmana Hospital, Tunis, Tunisia.
authors.forename: F
authors.initials: F
authors.lastname: Zhioua
authors.affiliation: Department of Obstetrics and Gynaecology, Taher Sfar Hospital, Mahdia, Tunisia.
authors.forename: H
authors.initials: H
authors.lastname: Bouchahda
authors.affiliation: Department of Obstetrics and Gynaecology, University Hospital of Bougatfa, Bizerte, Tunisia.|Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia.
authors.forename: M
authors.initials: M
authors.lastname: Mourali
mesh_terms: D000328:Adult; D037001:Directive Counseling; D004311:Double-Blind Method; D004312:Douglas' Pouch / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D015588:Observer Variation; D010353:Patient Education as Topic; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000473:pathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D012307:Risk Factors; D000267:Tissue Adhesions / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography; D014621:Vagina / Q000000981:diagnostic imaging*
keywords: adhesions; postoperative complications; sliding sign; transvaginal sonography