Certification of a Rural Endometriosis Clinic Leads to Improvement in the Diagnosis and Treatment of Endometriosis - a Retrospective Analysis.

Introduction: Endometriosis is a very common benign condition in women. In recent years certification of health care institutions has led to a more standardized care for endometriosis patients, aiming at improving the quality of diagnosis and treatment. The introduction of a common classification system facilitates quantification of disease extent. This study investigated whether certification of a rural endometriosis clinic ameliorated care in endometriosis patients.

Methods and material: A single-center retrospective data analysis was performed of all endometriosis patients that underwent surgery at the investigated institution, certified in 2019, for the years 2018-2022.

Results: Between 2018 and 2022, a total of 812 surgeries were performed, with certification significantly improving diagnostic and surgical outcomes. Post-certification, there was an increase in ultrasound utilization (47.7% vs. 35.6%, p = 0.007), greater recognition of adenomyosis (65.8% vs. 57.0%, p = 0.035), and higher rates of complete lesion removal (92.5% vs. 87.8%, p = 0.011). Pain outcomes also improved, with more patients achieving pain relief 12 months postoperatively (40.5% vs. 34.5%, p = 0.196 vs. < 0.001). Additionally, certification enhanced follow-up assessments (64.1% vs. 40.7%, p < 0.001) and documentation of rectal lesions in patients with dyschezia (p < 0.001), indicating a positive impact on overall care quality.

Conclusion: This study shows that certification significantly improved care for endometriosis patients. Certification enhanced diagnostic precision, increased the use of ultrasound, improved surgical outcomes, and enabled more nuanced application of the #Enzian scoring system. Follow-up assessments became more consistent, reflecting stronger quality control. Despite remaining challenges, certification elevated the clinic's standard of care and emphasized patient-centered management.