Can high histological confirmation rates be achieved for pelvic endometriosis?

This paper aims to determine the correlation between the diagnosis of endometriosis on the basis of the visualisation at laparoscopy and the histological diagnosis. Histological confirmation rates vary in the current literature. We retrospectively reviewed 160 patients over 2 years, who had laparoscopy for pelvic pain or suspected endometriosis. Our results showed higher histological confirmation rate compared with other studies. In addition, the use of CD10 IHC may increase detection rates further when the diagnosis is suspected but not confirmed by routine histology. Diagnosis of endometriosis is essential as it can influence patients' management.

Laparoscopic treatment of endometriosis in teenagers.

OBJECTIVES: To determine the frequency and severity of endometriosis in adolescent and teenager girls with chronic pelvic pain (CPP) who fail to respond to medical treatment and to evaluate the outcome of radical laparoscopic surgery for severe endometriosis. DESIGN: Retrospective review of case records of all girls under the age of 21 years who underwent diagnostic and/or operative laparoscopy for CPP unresponsive to medical treatment between January 2001 and December 2003. The operative findings and the response to surgery were retrospectively reviewed. RESULTS: Thirty-one girls were referred. No pelvic abnormalities were detected in 11 patients (35.5%). Endometriosis was detected in 11 (35.5%). Six had severe endometriosis. Other diagnoses included: non-functional non-endometriotic ovarian cyst (4 patients), functional ovarian cyst (1 patient), hydrosalpinx (bilateral, 1 patient; unilateral, 1 patient) and obstructed uterine horn (2 patients). Of those with severe disease all six were treated laparoscopically without complications. Five were rendered pain free and one had an improvement in symptoms. CONCLUSIONS: Endometriosis can occur in adolescent and teenager girls. Laparoscopy should be carried out in all adolescents and teenagers with CPP unresponsive to medical treatment. This the first study reporting the outcome of radical excision treatment for severe endometriosis in this age group and early results are encouraging.