Accuracy of laparoscopy for assessing patients with endometriosis.
OBJECTIVE
Diagnoses of endometriosis are based on observation of endometriotic lesions by means of laparoscopy, along with the pathological findings. The aim of this study was to evaluate the sensitivity and specificity of the macroscopic findings in relation to the histopathological findings. More specifically, we aimed to test the efficacy of laparoscopy alone for diagnosing endometriosis and to evaluate the laterality of endometriosis among the study population.


METHODS
Cross-sectional study on women undergoing laparoscopy due to pelvic pain or infertility, in the Gynecology Department of Hospital Santa Cruz in Curitiba, Paraná, Brazil, and Pontifícia Universidade Católica do Paraná.


METHODS
A total of 976 patients underwent laparoscopy and biopsy due to pelvic pain and/or infertility. We analyzed the laparoscopic and histopathological findings from patients with pelvic endometriosis (n = 468) and patients without endometriosis (n = 508).


RESULTS
In 468 (47.95%) of the cases, the clinical and laparoscopic findings were consistent with endometriosis, and this was confirmed histopathologically in 337 (34.5%). Among the remaining 508 patients, although the laparoscopy was performed for other reasons relating to acute pelvic pain, eight were diagnosed with endometriosis from histopathological examination of the pelvic specimens obtained. Therefore, endometriosis was confirmed in 345 patients (35.3%). In comparison with the histopathology, laparoscopy alone presented 97.68% sensitivity, 79.23% specificity, 72% positive predictive value and 98.42% negative predictive value.


CONCLUSIONS
Laparoscopy should be used in conjunction with histopathology for diagnosing endometriosis.
Almeida Filho
Dilermando Pereira de
DP
Center for Health and Biological Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil.
Oliveira
Laerte Justino de
LJ
Amaral
Vivian Ferreira do
VF
D000328:Adult; D001706:Biopsy; D004715:Endometriosis / Q000473:pathology*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007246:Infertility / Q000175:diagnosis / Q000473:pathology; D010535:Laparoscopy / Q000592:standards*; D017699:Pelvic Pain / Q000175:diagnosis / Q000473:pathology; D010388:Pelvis / Q000473:pathology*