Elsevier

Fertility and Sterility

Volume 76, Issue 5, November 2001, Pages 929-935
Fertility and Sterility

Endometriosis
Validation study of nonsurgical diagnosis of endometriosis

https://doi.org/10.1016/S0015-0282(01)02736-4Get rights and content
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Abstract

Objective: To determine whether the surgical diagnosis of endometriosis can be predicted using symptoms, signs, and ultrasound findings.

Design: Prospective study (study sample); retrospective record review (test sample).

Setting: Hospital of Desio (study sample) and Mangiagalli Hospital (test sample), Italy.

Patient(s): Ninety women scheduled to undergo laparoscopy or laparotomy (study sample); 120 women who underwent laparoscopy (test sample).

Intervention: The study sample group was interviewed before surgery about infertility and dysmenorrhea, dyspareunia, and noncyclic pelvic pain and each member had a pelvic examination and a transvaginal ultrasound. At surgery, endometriosis was noted. For the test sample, the same information was abstracted from medical records after laparoscopy.

Main Outcome Measure(s): The ability of symptoms, signs, and ultrasound to predict endometriosis at surgery. A classification tree was developed with the study sample and evaluated with the test sample.

Result(s): Ovarian endometriosis, but not nonovarian endometriosis, could be reliably predicted with noninvasive tools. Ultrasound and examination best predicted ovarian endometriosis, correctly classifying 100% of cases with no false positive diagnoses in the study sample. Similar results were found in the test sample.

Conclusion(s): Noninvasive tools may be used to identify women with ovarian, but not nonovarian endometriosis, with excellent agreement with surgical diagnosis.

Keywords

Endometriosis
endometriomas
epidemiology
laparoscopy
infertility
dyspareunia
dysmenorrhea
pelvic pain

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Supported by grant nos. R82471 from the US Environmental Protection Agency, R01 ES07171 and F06 TWO2075-01 from the National Institutes of Health, and EA-M1977 from the Endometriosis Association.