Laparoscopy in the diagnosis of endometriosis

Question 1

Good quality laparoscopy in diagnosis of endometriosis should include

Answer 1

• Uterus and adnexa
• Peritoneum of ovarian fossae, vesico-uterine fold, Douglas and pararectal spaces
• Rectum and sigmoid (isolated sigmoid nodules)
• Appendix and caecum
• Diaphragm
• Speculum examination and palpation of the vagina and cervix under laparoscopic control for buried nodules

Question 2

Positive and negative laparoscopy for endometriosis

Answer 2

• All laparoscopy should have histology
• A neg laparoscopy is highly reliable for absence of endometriosis
• A neg histology does not exclude endometriosis