{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T01:34:32Z","timestamp":1789176872772,"version":"build-2803163510"},"reference-count":11,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,8,2]],"date-time":"2020-08-02T00:00:00Z","timestamp":1596326400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>\u00a0To determine the prevalence of occult microscopic endometriosis in patients with chronic pelvic pain and negative laparoscopy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cross\u2010sectional study included women who underwent laparoscopic evaluation for chronic pelvic pain by three fellowship\u2010trained gynecologic surgeons at a community hospital from January 2011 to December 2016. The aim was to evaluate the prevalence of microscopic endometriosis in this population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>\u00a0In 142 patients with clinically negative peritoneum on laparoscopy, 39% had occult microscopic endometriosis. Cramping pain score during menses was found to be lower in the positive biopsy group (6.9 vs 8.0, <jats:italic>P<\/jats:italic>=0.046). No differences were appreciated in age of menarche, pain during various parts of the menstrual cycle, or duration of symptoms. The biopsy\u2010positive group had a younger age at time of evaluation, although not statistically significant (<jats:italic>P<\/jats:italic>=0.179). Current use of hormones affected neither biopsy results nor menstrual or pain characteristics. Detection was similar between robotic and laparoscopic cases and operative morbidity was minimal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Occult microscopic endometriosis may be present in approximately 39% of patients with clinically negative appearing peritoneum undergoing laparoscopy for chronic pelvic pain. Given this, biopsies should be performed in patients undergoing laparoscopy who do not have visible lesions.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.13303","type":"journal-article","created":{"date-parts":[[2020,7,9]],"date-time":"2020-07-09T15:41:21Z","timestamp":1594309281000},"page":"260-266","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Prevalence of occult microscopic endometriosis in clinically negative peritoneum during laparoscopy for chronic pelvic pain"],"prefix":"10.1002","volume":"151","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1951-9374","authenticated-orcid":false,"given":"Ashley L.","family":"Gubbels","sequence":"first","affiliation":[{"name":"Division of Advanced Gynecology and Pelvic Pain Department of Obstetrics and Gynecology St. Joseph\u2019s Hospital and Medical Center Phoenix AZ USA"},{"name":"Phoenix Integrated Residency in Obstetrics and Gynecology Phoenix AZ USA"},{"name":"Department of Obstetrics and Gynecology University of Rochester Medical Center Rochester NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences University of Rochester Medical Center Rochester NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna","family":"Kreher","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Rochester Medical Center Rochester NY USA"},{"name":"Department of Psychiatry University of Rochester Medical Center Rochester NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasha","family":"Mehandru","sequence":"additional","affiliation":[{"name":"Phoenix Integrated Residency in Obstetrics and Gynecology Phoenix AZ USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Castellanos","sequence":"additional","affiliation":[{"name":"Division of Advanced Gynecology and Pelvic Pain Department of Obstetrics and Gynecology St. Joseph\u2019s Hospital and Medical Center Phoenix AZ USA"},{"name":"Phoenix Integrated Residency in Obstetrics and Gynecology Phoenix AZ USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nita A.","family":"Desai","sequence":"additional","affiliation":[{"name":"Division of Advanced Gynecology and Pelvic Pain Department of Obstetrics and Gynecology St. Joseph\u2019s Hospital and Medical Center Phoenix AZ USA"},{"name":"Phoenix Integrated Residency in Obstetrics and Gynecology Phoenix AZ USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Hibner","sequence":"additional","affiliation":[{"name":"Division of Advanced Gynecology and Pelvic Pain Department of Obstetrics and Gynecology St. Joseph\u2019s Hospital and Medical Center Phoenix AZ USA"},{"name":"Phoenix Integrated Residency in Obstetrics and Gynecology Phoenix AZ USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,8,2]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.2217\/whe.15.30"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006254-199306000-00001"},{"key":"e_1_2_7_4_1","first-page":"1045","article-title":"Characteristics of women undergoing hysterectomy for chronic pelvic pain: Prevalence and risk factors for endometriosis","volume":"22","author":"Mowers EL","year":"2015","journal-title":"Obstet Gynecol"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1083-3188(97)70085-8"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1083-3188(96)70021-9"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/GCO.0000000000000222"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(16)49598-1"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(16)53823-0"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(16)53571-7"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/HUMREP\/11.2.387"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/det438"}],"container-title":["International Journal of Gynecology &amp; 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