Laparoscopic evidence of upper genital schistosomiasis

This prospective study aimed at estimating the proportion of upper genital schistosomiasis in patients submitted to video-assisted laparoscopy and to describe carefully the bilharzial lesions seen at laparoscopy. Four hundred and thirty-four patients submitted to videolaparoscopy were included in this study. The pelvis was carefully explored for evidence of recent or old upper genital tract chronic inflammation. Suspicious areas like nodules, masses, vascular lesions, adhesions, pathologic tubes or ovarian cysts were biopsied. Positive cases of schistosomiasis were submitted to a thorough immunological evaluation. Diagnostic laparoscopy was carried out in 185 cases while the remaining patients required operative intervention. Biopsy was taken from 128 cases (29.8%) which revealed schistosomiasis in four cases only (0.9%) who demonstrated high titre of antibodies against Schistosoma haematobium . Despite being a rare disease, upper genital schistosomiasis should be considered as a possible cause in all cases of adhesions, tubal, peritoneal or ovarian lesions, if the patient comes from an endemic area.