Diagnosis of Endometriosis at Laparoscopy: A Validation Study Comparing Surgeon Visualization with Histologic Findings

Gratton SM, Sara-Michelle Gratton, Abdul Jamil Choudhry, Choudhry AJ, Vilos GA, George A Vilos, Vilos A, Angelos Vilos, Angelos G. Vilos, Kristina Baier, Baier K, Simonne Holubeshen, Holubeshen S, Maria Cassandra Medor, Medor MC, Stéphanie Mercier, Mercier S, Nguyen V, Vincent Nguyen, Innie Chen
Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC · 2021 · vol. 44(2) , pp. 135–141 · doi:10.1016/j.jogc.2021.08.013 · PMID:34562632 · W3201415715
article OA: closed CC0 ⤵ 28 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-13 ⓘ

This study validated the accuracy of surgeon visualization during laparoscopy for diagnosing endometriosis against definitive histologic findings.

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Abstract

ObjectiveThis study aimed to evaluate the validity of laparoscopic visualization for the diagnosis of endometriosis compared with histopathology.MethodsWe conducted a retrospective chart review at a tertiary care hospital in Canada for the period of April 1, 2016 to March 31, 2017. Of 1069 women, 96 were selected for having undergone laparoscopic visualization and concurrent histopathological biopsy for suspected endometriosis. Standard measures of validity for diagnostic tests (sensitivity, specificity, positive predictive and negative predictive values, accuracy) were used.ResultsMean age of the 96 women included was 40 ± 7.2 years, and median gravidity and parity were 1 (IQR 0-3) and 0 (IQR 0-2), respectively. Common symptoms were abdominal and pelvic pain (41.7%), menstrual bleeding concerns (34.4%), dysmenorrhea (29.2%), and infertility (8.3%). Approximately one-third of women had endometriomas (31.3%), while more than half had deep infiltrating endometriosis (59.4%). The diagnosis of endometriosis was made by surgeons at laparoscopic visualization in 82.3% of women and by histopathology in 74.0%. Using histopathology as the gold standard, sensitivity for laparoscopic visualization was 90.1% (95% CI 81.0-95.1), while specificity was 40.0% (95% CI 23.4-59.3). Positive and negative predictive values were 81.0% (95% CI 71.0-88.1) and 58.8% (95% CI 36.0-78.4), respectively; and the accuracy was 77.1% (95% CI 67.7-84.4).ConclusionAlthough laparoscopic visualization had relatively high sensitivity and positive predictive value, its specificity and negative predictive value were relatively low. These findings support the use of laparoscopic visualization with histopathological analysis for accurate diagnosis of endometriosis.

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Condition tags

endometriosischronic_pelvic_pain

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Laparoscopy Surgeons Adult Female Humans Middle Aged Pelvic Pain Pelvic Pain Pelvic Pain Pregnancy Retrospective Studies

Citation neighborhood

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