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• W1985736134 abstract "The role of laparoscopy as the gold standard for the diagnosis of pelvic endometriosis is questioned. An accurate histologic analysis fails to confirm the presence of endometriosis in a substantial proportion of patients diagnosed at laparoscopy. The role of laparoscopy as the gold standard for the diagnosis of pelvic endometriosis is questioned. An accurate histologic analysis fails to confirm the presence of endometriosis in a substantial proportion of patients diagnosed at laparoscopy. We thank all of the discussants for their thoughtful comments. Dr. Sharpe-Timms raises important methodologic concerns (1Sharpe-Timms K.L. Defining endometrial cells the need for improved identification at ectopic sites and characterization in eutopic sites for developing novel methods of management for endometriosis.Fertil Steril. 2005; 84: 35-37Abstract Full Text Full Text PDF PubMed Scopus (15) Google Scholar). We fully agree on the need for a standardized morphologic definition of endometriotic lesions. This would help both clinically and in scientific research, making results from different studies easy to compare. On the other hand, definitions and interpretations of endometriotic lesions vary in particular for non-classic lesions, whereas classic implants are more consistently recognized as puckered/nodular lesions characterized by varying degrees of fibrosis and pigmentation (from brown to black). This definition was referred to in our article (2Shaw R.W. An atlas of endometriosis. The Parthenon Publishing Group, Casterton Hall, Carnforth1993Google Scholar). It is possible that histologic examination could fail to confirm existing endometriosis. However, in our study, visible lesions were excised in toto, whereas the average sample size examined by the pathologist was 1.5–2 mm3, with 20 sections per biopsy being evaluated. This standard procedure should be accurate enough for detecting endometriotic tissue in samples of such size. We agree with Dr. Sharpe-Timms’ (1Sharpe-Timms K.L. Defining endometrial cells the need for improved identification at ectopic sites and characterization in eutopic sites for developing novel methods of management for endometriosis.Fertil Steril. 2005; 84: 35-37Abstract Full Text Full Text PDF PubMed Scopus (15) Google Scholar) and Dr. Osteen and colleagues’ (3Osteen K.G. Bruner-Tran K.L. Eisenberg E. Endometrial biology and the etiology of endometriosis.Fertil Steril. 2005; 84: 33-34Abstract Full Text Full Text PDF PubMed Scopus (22) Google Scholar) suggestions that improved laboratory methods for identifying endometriosis are needed. However, they should be cost-effective and suitable for routine use in any laboratory. So far, laparoscopy with histologic analysis remains the gold standard. We are aware of the potential presence of invisible endometriosis, as pointed out by Dr. Evers and coworkers (4Evers J.L.H. Dunselman G.A.J. Groothius P. Now you see them, now you don’t.Fertil Steril. 2005; 84: 31-32Abstract Full Text Full Text PDF PubMed Scopus (17) Google Scholar). However, to date there is no evidence that this type of endometriosis could progress and become clinically relevant in all cases. Therefore, whether these patients should receive a specific treatment remains an unanswered question." @default.
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• W1985736134 date "2005-07-01" @default.
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• W1985736134 title "Laparoscopic visualization with histologic confirmation represents the best available option to date in the diagnosis of endometriosis" @default.
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