Determining the Valubility of Visual Findings of Laparoscopy in Diagnosing the 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 correlation between the visual and histological diagnosis of endometriosis by comparing peritoneal findings identified at laparoscopy in a diagnostic trial with a standardized technique; including complete excision of lesions suggestive of endometriosis and systematic biopsies of normal appearing pelvic peritoneum. This study was performed in Mahdieh Hospital and IRHRC from 1383 to 1384. A diagnostic study of 30 patients (15- 45 yr.) undergoing diagnostic laparoscopy for the evaluation of chronic pelvic pain, infertility, dysmenorrhea and dysparonia was carried out (average age was 28.6 ± 5.14 (mean ±SD)). All suggestive areas of endometriosis were excised and examined pathologically. Additionally, peritoneal biopsy specimens were obtained from normal appearing peritoneum to rule out microscopic endometriosis. The positive predictive value, sensitivity, negative predictive value and specificity of visually identified endometriosis were determined in comparison with histological findings (definitive diagnosis). The mean prevalence of endometriosis abnormalities in visual and histological diagnosis were 63% and 42%, respectively. The measured values, therfore, for visual versus histological diagnosis of endometriosis were 42.1% for positive predictive value, 88.8% for sensitivity, 90.9% for negative predictive value and 47.6% for specificity. A diagnosis of endometriosis should be established only after histological confirmation.