DIAGNOSTIC ACCURACY OF LAPAROSCOPIC VISUAL INSPECTION OF PELVIC ENDOMETRIOSIS

Background: Endometriosis is the presence of endometrial glands or stroma in sites other than reproductive lives. It is associated with symptoms such as pelvic pain, dysmenorrhea, painful sexual intercourse and infertility. Endometriosis can only objectively be confirmed by visualization. This is mainly done by laparoscopy or laparotomy. Laparoscopy allows inspection of the entire pelvis and the extent of disease recorded using a classification system.Objective: To assess accuracy of visual diagnosis of laparoscopically excised visceral and peritoneal abnormalities suggestive of endometriosis in comparison to histopathological diagnosis.Patients and methods: This were a cross sectional study for accuracy of a diagnostic test for diagnosis of pelvic endometriosis, conducted on 50 women at laparoscopy unit, Obstetrics and Gynecology Departments Al-Hussein University Maternity Hospital, during the period from July 2019 to October 2021. This study included women planned to undergo diagnostic or operative intervention laparoscopy for pain and/or infertility related to a suggestive diagnosis of pelvic endometriosis.Results: Pelvic pain was the most frequent clinical presentation with a percentage of 68% as pelvic pain, dyspareunia 46%, dysmenorrhea 38% and infertility 24%. Endometriosis was found in about three quarters of cases of suspected cases. Our results pointed the diagnostic accuracy of visualization by laparoscopy in diagnosis of endometriosis. uterus was the most accurate site (96%), followed by right ovary, left ovary, right ovarian fossa with percentage (92%) each, Douglas pouch and peritoneum (88%) each and left ovarian fossa (86%).Conclusion: Laparoscopy, particularly a first procedure served both diagnostic and therpeuatic purpose, the intial step was expolaration of pelvis and abdomen. Diagnosis of endometrisos by visual inspection of lesions at laparoscopy was considered satisfactory.