Endometriosis Quality of Life Cohort Study: Long-term Impact of Radical Laparoscopic Excision of Endometriosis.

Abstract

Objectives: The objectives of this study were to determine if radical laparoscopic excision of endometriosis (RLEE) improves long-term outcomes in the quality of life (QOL) and symptomatology experienced by women with the disease. Secondary objectives include recurrence and reoperation rates and impact on fertility.

Materials and methods: Prospective observational cohort study Patients who underwent surgical management of histologically confirmed endometriosis completed pre- and postoperative QOL questionnaires.

Results: Baseline preoperative scores on QOL questionnaires were lower than the population norms. Overall, 63.0% of patients improved their global health scores, and 57.5% of patients improved their health state scores from baseline to the most recent follow-up. On the Short Form-12 questionnaire, 63% of patients improved their physical and/or mental scores. Overall improvement was shown in Visual Analog Scale pain scores in menstrual pain (79.2% improved, median improvement 3, P < 0.001, n = 72), noncyclical pelvic pain (64.4% improved, median improvement 2, P < 0.001, n = 73), dyschezia (63.9% improved, median improvement 2, P < 0.001, n = 72), and dyspareunia (65.6% improved, median improvement 1, P = 0.002, n = 64 pairs). There was a significant reduction in discomfort 1-2 years after primary surgery among sexually active patients (n = 23, pre- vs. postmedian score 4 vs. 2, P = 0.005). Repeat surgery was required in 36% of patients and 77.1% of those wishing to, achieved a successful pregnancy.

Conclusion: RLEE significantly improves global health scores, with this improvement lasting up to 10 years following index surgery. It is also suggested that this management option has the capability of improving fertility outcomes in women with endometriosis.