Evaluation of Diagnostic Visual Findings at Laparoscopy in Endometriosis

Endometriosis has been widely implicated as one of the causes of chronic pelvic pain, dysmenorrhea and infertility. The purpose of our study was to define the presumed correlation between visual and histologic diagnostic features of endometriosis based on the peritoneal findings identified in laparoscopy as a diagnostic trial with a standardized technique. So, all the specimens including complete excised lesions suggestive of endometriosis and systematic biopsies of normal appearing pelvic peritoneum were analyzed. This study was performed in Mahdieh hospital and IRHRC1 between 2004 and 2005. A diagnostic study of 30 patients (14 to 45 years) undergoing diagnostic laparoscopy for the evaluation of chronic pelvic pain, infertility, dysmenorrhea and dyspareunia was carried out (average age was 28.6±5.14). All areas suggestive of endometriosis were excised and examined pathologically. Peritoneal biopsy specimens were obtained from areas of normal appearing peritoneum to rule out microscopic endometriosis. The positive predictive value, sensitivity, negative predictive value and specificity were determined for identified endometriosis versus the histological findings. The mean prevalence of abnormalities visually consistent with endometriosis was 63% while 42% confirmed histologically. The positive predictive value was 42.1%, sensitivity 88.8%, negative predictive 90.9% and specificity 47.6% for visual versus histological diagnosis of endometriosis. A diagnosis of endometriosis should be established only after histologic confirmation.