Peritoneal flushing and biopsy in laparoscopically diagnosed endometriosis

A series of 74 patients with endoscopically proven endometriosis were selected for evaluation of usefulness of peritoneal flushing and aspiration in the early diagnosis of pelvic endometriosis. Forty-three patients had either an ovarian or a peritoneal biopsy performed after peritoneal lavage. The results indicate that 25% of the washings performed were successful in demonstrating endometrial glands or stroma. On the other hand, 72% of the patients on whom biopsies were performed showed endometrial tissue, and biopsy failures were mainly related to the technical difficulties of the ovarian biopsy. In 46% of the histologically proven cases of endometriosis, peritoneal lavage failed to demonstrate endometrial tissue. Conversely, in 4.6% of the negative biopsy cases, peritoneal lavage showed endometrial glands. We conclude that exfoliative cytology is not a useful tool in the diagnosis of endometriosis. On the other hand, we were able to make the diagnosis by biopsy in more than 70% of the patients on whom biopsies were performed.