Moawad NS, et al. - The authors aimed at analyzing the rate of recurrent pain and reoperation for patients who underwent laparoscopic excision of endometriosis. They also examined the impact of surgery on long-term quality of life and the effect on fertility following laparoscopic excision of endometriosis. As per findings, this procedure had a low rate of reoperation, and long-term improvement in pelvic pain, sexual function, quality of life and fertility outcomes, with a high satisfaction rate.

Methods

• Patients who underwent laparoscopic surgery were retrospectively studied for pelvic pain and/or endometriosis at a tertiary care university referral center for minimally invasive gynecologic surgery.
• Researchers performed a retrospective chart review as well as a prospective online and telephone questionnaire to analyze long term outcomes, pain recurrence, reoperation and fertility outcomes.
• They utilized Quality of life validated questionnaire (SF-12) and the Female Sexual Function Index (FSFI).

Results

• Laparoscopic surgery was performed on 239 subjects for pelvic pain from July 2010 to June 2015 who were identified from ICD-9 codes representing various pelvic pain symptoms.
• In this study, 69 subjects consented and filled out a comprehensive questionnaire.
• Endometriosis confirmed on pathology in 39 of these subjects.
• Researchers noticed mean follow-up period of 27.13.
• Laparoscopic excision was performed on 84.6% of the patients with endometriosis; further surgical intervention was required in 7.7% of the patients with endometriosis following the index procedure.
• At the time of the survey, two thirds of the patients with endometriosis (N=26) were still pain-free.
• Patients showing recurrence of pain following surgery were pain free for an average of 1.958 years before recurrence.
• A history of infertility for an average of 1.889 years prior to surgery was observed in one third of the endometriosis patients (N=13).
• They noticed that 76.9% of previously infertile patients attempted to conceive following surgery with 80% success rate.
• In each quality of life measurement and most sexual function indices analyzed, the endometriosis subjects showed significant improvements.