Endometriosis: Correlation between histologic and visual findings at laparoscopy

Objective: The purpose of this study was to correlate the diagnosis of endometriosis on the basis of visualization at laparoscopy with the pathologic diagnosis. Study Design: A prospective study of 44 patients undergoing laparoscopy for the evaluation of chronic pelvic pain was carried out. All area...

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Published in:American journal of obstetrics and gynecology 2001-06, Vol.184 (7), p.1407-1413
Main Authors: Walter, Andrew J., Hentz, Joseph G., Magtibay, Paul M., Cornella, Jeffrey L., Magrina, Javier F.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Endometriosis
Endometriosis - epidemiology
Endometriosis - pathology
Female
histology
Humans
Laparoscopy
Middle Aged
Predictive Value of Tests
Prevalence
Prospective Studies
Sensitivity and Specificity
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Summary:Objective: The purpose of this study was to correlate the diagnosis of endometriosis on the basis of visualization at laparoscopy with the pathologic diagnosis. Study Design: A prospective study of 44 patients undergoing laparoscopy for the evaluation of chronic pelvic pain was carried out. 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. All lesions were identified by anatomic site. Visual and histologic American Fertility Society scores were compared. The positive predictive value, sensitivity, negative predictive value, and specificity were determined for visually identified endometriosis versus the histologic correlate. Results: The mean prevalence of abnormalities visually consistent with endometriosis was 36%, with 18% confirmed histologically. The positive predictive value was 45%; sensitivity, 97%; negative predictive value, 99%; and specificity, 77%; for visual versus histologic diagnosis of endometriosis. Thirty-six percent of the diagnoses were downstaged on the basis of histologic findings. Conclusion: A diagnosis of endometriosis should be established only after histologic confirmation. (Am J Obstet Gynecol 2001;184:1407-13.)
ISSN:0002-9378
DOI:10.1067/mob.2001.115747