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Prevalence of occult microscopic endometriosis in clinically negative peritoneum during laparoscopy for chronic pelvic pain
Author(s) -
Gubbels Ashley L.,
Li Rui,
Kreher Donna,
Mehandru Natasha,
Castellanos Mario,
Desai Nita A.,
Hibner Michael
Publication year - 2020
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.13303
Subject(s) - medicine , endometriosis , pelvic pain , occult , laparoscopy , biopsy , population , surgery , gynecology , radiology , pathology , alternative medicine , environmental health
Abstract Objective To determine the prevalence of occult microscopic endometriosis in patients with chronic pelvic pain and negative laparoscopy. Methods A retrospective cross‐sectional study included women who underwent laparoscopic evaluation for chronic pelvic pain by three fellowship‐trained gynecologic surgeons at a community hospital from January 2011 to December 2016. The aim was to evaluate the prevalence of microscopic endometriosis in this population. Results In 142 patients with clinically negative peritoneum on laparoscopy, 39% had occult microscopic endometriosis. Cramping pain score during menses was found to be lower in the positive biopsy group (6.9 vs 8.0, P =0.046). No differences were appreciated in age of menarche, pain during various parts of the menstrual cycle, or duration of symptoms. The biopsy‐positive group had a younger age at time of evaluation, although not statistically significant ( P =0.179). Current use of hormones affected neither biopsy results nor menstrual or pain characteristics. Detection was similar between robotic and laparoscopic cases and operative morbidity was minimal. Conclusion Occult microscopic endometriosis may be present in approximately 39% of patients with clinically negative appearing peritoneum undergoing laparoscopy for chronic pelvic pain. Given this, biopsies should be performed in patients undergoing laparoscopy who do not have visible lesions.