Endometriosis Diagnosis correlation of Laparoscopic visualization and histopathology confirmation in low Resource setting

2021 
Background: Endometriosis is enigmatic clinical entity which is described as the location of the endometrial tissue external of the uterine cavity. Endometriosis constitutes a serious health issue due to its high affliction of 10% of reproductive women. With limited resources in Africa, it is essential to assess whether diagnosis of endometriosis by laparoscopic visualization can be used as a substitute for histology. Objective: To correlate the diagnosis of endometriosis by laparoscopic visualization and the histological confirmation of the biopsy taken. Methods: A prospective cross sectional study with a sample size of 443 was undertaken in the diagnosis of endometriosis among Africans in Nairobi, Kenya from March 2019 to March 2021. Women undergoing laparoscopy were screened for endometriosis by visualization and a biopsy was taken for histopathology. Diagnosis of endometriosis by visualization was correlated with histological confirmed endometriosis. Results: Women with a diagnosis of endometriosis through laparoscopic visualization were found to be 77 (17.4%) and 30 (6.8%) had positive histology for endometriosis. Laparoscopic visualization diagnosis had a low positive predictive value of 39%. Conclusion: Laparoscopic visualization diagnosis had a low positive predictive value of 39% and this did not correlate with histopathologic diagnosis. It is essential to perform biopsy with histopathology for the confirmation of endometriosis.
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