Caspian Journal of Reproductive Medicine

en Agreement between laparoscopic and histopathological diagnosis in women with advanced endometriosis: A retrospective cross-sectional study Reproductive Health Reproductive Health پژوهشي Original Research <div style="text-align: justify;"> Background: Laparoscopy is widely used for the surgical diagnosis of endometriosis, whereas histopathological examination remains the reference standard for confirming the disease. Although visual diagnosis during laparoscopy is considered reliable for typical lesions, its agreement with histopathological findings may vary according to lesion location. This study aimed to evaluate the agreement between laparoscopic diagnosis and histopathological confirmation in women with advanced endometriosis. Methods: This retrospective cross-sectional study reviewed the medical records of women aged 15–55 years who underwent laparoscopic surgery for stage III or IV endometriosis between 2016 and 2021 at two referral centers in Tehran and Alborz, Iran. Endometriosis was staged according to the revised American Society for Reproductive Medicine (rASRM) classification. Laparoscopic findings were compared with histopathological results, and overall as well as site-specific percentage agreement was calculated. Results: A total of 1,836 women were included. Overall, laparoscopic and histopathological diagnoses were concordant in 1,659 cases (90.4%), whereas discordance was observed in 177 cases (9.7%). Agreement exceeded 95% for lesions involving the uterosacral ligaments, right ovary, recto cervical region, and posterior vagina. Lower agreement was observed for appendiceal (57.3%) and omental (75.0%) lesions, suggesting that concordance between laparoscopic and histopathological findings varied according to anatomical location. Conclusion: Laparoscopic findings demonstrated a high level of agreement with histopathological diagnosis in women with advanced endometriosis, particularly for lesions at common pelvic sites. However, lower agreement at certain anatomical locations indicates that histopathological examination remains an important component of diagnosis, especially for atypical lesions or when alternative pathological conditions are suspected. Because agreement was evaluated using descriptive measures, further prospective multicenter studies incorporating comprehensive diagnostic agreement and diagnostic accuracy analyses are warranted to validate these findings.</div> Abortion, Heart Diseases, Maternal Mortality, Premature Birth, Pulmonary Arterial, Hypertension 4 10 http://caspjrm.ir/browse.php?a_code=A-12-143-7&slc_lang=en&sid=1 Roya Padmehr 10031947532846002747 10031947532846002747 No Amirhossein Shahbandi 10031947532846002748 10031947532846002748 No Maryam Hashemnezhad 10031947532846002749 10031947532846002749 No Samira Abdollahi 10031947532846002750 10031947532846002750 No Mina Ataei ataee.mina20@gmail.com 10031947532846002751 10031947532846002751 Yes Reproductive Biotechnology Research Centre, Avicenna Research Institute (ARI), Academic Centre for Education, Culture and Research (ACECR), Tehran, Iran; Department of Obstetrics and Gynecology, Social Determinants of Health, Research Center, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran Zahra Sehat 10031947532846002752 10031947532846002752 No