Using location, color, size, and depth to characterize and identify endometriosis lesions in a cohort of 133 women.
OBJECTIVE
To correlate histology with endometriosis characteristics.


METHODS
Secondary data analysis.


METHODS
Government research hospital.


METHODS
One hundred thirty-three women with chronic pelvic pain and endometriosis who underwent laparoscopic surgery between 1999 and 2004.


METHODS
Laparoscopic excision of lesions, including recording of lesion characteristics and surgical impression of the lesions.


METHODS
All biopsies were sent for histological examination for endometriosis, and surgical and histological findings were compared.


RESULTS
Three hundred fifty-seven of 544 lesions believed to be endometriosis by the surgeon had positive histology. Mixed-color lesions most commonly contained endometriosis (76%), with the percentage of positive lesions being similar between single-color groups. Among subtle (red or white) lesions, 58% (164/283) were positive for endometriosis. Thirty women had only red or white lesions, and 18 (60%) had at least one lesion positive for endometriosis. Lesions were most commonly located in the cul-de-sac (64%), utero-sacral ligaments (68%), and ovarian fossa (70%).


CONCLUSIONS
Wide, deep, mixed-color lesions in the cul-de-sac, the ovarian fossa, or the utero-sacral ligaments had the highest frequency of endometriosis. More than half of subtle lesions had endometriosis. These results should be considered when diagnosing endometriosis.
Reproductive Biology and Medicine Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland 20892-1109, USA.
Barbara J
BJ
Stegmann
Ninet
N
Sinaii
Shannon
S
Liu
James
J
Segars
Maria
M
Merino
Lynnette K
LK
Nieman
Pamela
P
Stratton
D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D004715:Endometriosis / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D004965:Estrogen Antagonists / Q000627:therapeutic use; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D010053:Ovary / Q000473:pathology; D020849:Raloxifene Hydrochloride / Q000627:therapeutic use; D001743:Urinary Bladder / Q000473:pathology; D014599:Uterus / Q000473:pathology
D004965:Estrogen Antagonists; D020849:Raloxifene Hydrochloride