Accuracy of laparoscopy for assessing patients with endometriosis

Dilermando Pereira de Almeida Filho, Laerte Justino de Oliveira, Vivian Ferreira do Amaral
Sao Paulo medical journal = Revista paulista de medicina · 2008 · vol. 126(6) , pp. 305–308 · doi:10.1590/s1516-31802008000600002 · PMID:19274315 · W2050130192
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This study evaluated laparoscopy for diagnosing endometriosis, finding it has high sensitivity (97.68%) and negative predictive value (98.42%) compared to histopathology.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This cross-sectional study evaluated the diagnostic accuracy of macroscopic findings on laparoscopy compared with histopathology in 976 women undergoing laparoscopy for pelvic pain and/or infertility, with 468 suspected cases of pelvic endometriosis and 508 without endometriosis suspicion. Laparoscopy alone showed high sensitivity (97.68%) but only moderate specificity (79.23%), with a positive predictive value of 72% and a negative predictive value of 98.42% when compared to histopathological confirmation. The paper’s limitation is that it focuses on visual impression during laparoscopy and uses histopathology of biopsy specimens as the reference standard for determining endometriosis. This paper is centrally about endometriosis — it quantifies how accurate laparoscopy’s macroscopic assessment is for diagnosing endometriosis relative to histopathology.

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Abstract

CONTEXT AND 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. DESIGN AND SETTING: 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. CONCLUSION: Laparoscopy should be used in conjunction with histopathology for diagnosing endometriosis.

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Condition tags

mesh:D004715mesh:D017699endometriosisinfertility

MeSH descriptors

Endometriosis Laparoscopy Pelvis Adult Biopsy Endometriosis Epidemiologic Methods Female Humans Infertility Infertility Infertility Laparoscopy Pelvic Pain Pelvic Pain Pelvic Pain Pelvis

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