Utility of preoperative examination and magnetic resonance imaging for diagnosis of anterior vaginal wall masses

Int Urogynecol J. 2012 Aug;23(8):1055-61. doi: 10.1007/s00192-012-1666-6. Epub 2012 Feb 3.


Introduction and hypothesis: 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.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Diagnostic Errors / prevention & control
  • Female
  • Gynecologic Surgical Procedures
  • Gynecological Examination / methods*
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Middle Aged
  • Postoperative Period
  • Preoperative Care / methods*
  • Retrospective Studies
  • Urethra / pathology
  • Vagina / pathology*
  • Vaginal Diseases / diagnosis*
  • Vaginal Diseases / pathology
  • Vaginal Diseases / surgery
  • Young Adult