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REVIEW: Accuracy of laparoscopy in the diagnosis of endometriosis: a systematic quantitative review
Author(s) -
Wykes Catherine B.,
Clark T. Justin,
Khan Khalid S.
Publication year - 2004
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.2004.00433.x
Subject(s) - obstetrics and gynaecology , medicine , obstetrics , university hospital , general hospital , gynecology , family medicine , pregnancy , genetics , biology
Endometriosis is a common gynaecological condition found in women of reproductive age. – 3 The condition is associated with chronic pelvic pain and infertility, which can result in reduced quality of life, psychological morbidity and work absenteeism. Diagnosis is invariably made following laparoscopic inspection of the pelvis. The appearance of endometriosis varies, but classically is seen as areas of discolouration (so-called implants or deposits) or peritoneal defects and scarring. More extensive disease can lead to formation of adhesions and cysts. Both medical and surgical treatments for endometriosis are associated with considerable morbidity and frequently short term relief of chronic pelvic pain symptoms. In subfertility, laparoscopic ablative treatment is associated with improved reproductive outcome. Accurate diagnosis is therefore essential to optimally target women likely to benefit from treatment, to reduce unnecessary morbidity and to efficiently use health service resources. Advances in endoscopic instrumentation have facilitated peritoneal tissue biopsy for histological assessment. The existing data supporting the use of laparoscopy in visual diagnosing endometriosis have seldom been validated against histological findings confirmed independently using an established gold standard. Individual studies on this subject are small, leading to imprecise estimates of diagnostic accuracy. We therefore undertook a quantitative systematic review to obtain more precise accuracy estimates and to explore reasons for heterogeneity.