The characteristics of endometriotic lesions in 136 women with peritoneal endometirosis

Objective Laparoscopy is the standard method to visually identify endometriotic lesions under magnification within and outside the pelvis.The aim of this study was to analyze the accuracy of laparoscopic diagnosis of various endometriotic lesions.Methods Endometriosis was clinical suspected in 136 women,who underwent laparoscopy and endometriotic sites diagnosed under endoscope were obtained biopsies,followed by pathologic examination.The laparoscopic diagnosis and pathology were compared.Results The pathology confirmed endometriosis in 115 patients (84.6%),no evidence of endometriosis in 21 patients (15.4%).100% of “red” lesions,92% of“black” lesions,and 31% of “white” lesions of endometriosis under laparoscope were confirmed pathologically.Of the 236 various suspected endometriotic lesions observed,210 (89%) were confirmed pathologically. The accuracy of laparoscopic diagnosis in lesions at the ovarian fossa was 12/12 (100%),uterosacral ligaments 97/110 (88.2%),posterior surface of the broad ligaments 94/99 (94.9%),pelvic lateral walls 22/25 (88.4%).vesicouterine fold of the peritoneum 54.5%; ureturs 70% and bowel serosa,33.3%.Conclusions Endometriosis appears as vary lesions,which may be confused with nonendometriotic lesions. Non-pathology-based diagnosis may lead to unnecessary treatment and surgery,preventing from proper therapy.Therefore,a carefully pathology confirmed diagnosis should still be the first step in diagnosis and treatment of endometriosis.