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D Tiringer, AS Pedrini, M Gstottner, H Husslein, L Kussel, A Perricos, R Wenzl
Background: Endometriosis is one of the most common gynecological illnesses causing extensive psychological, physical and social impact on patient’s life and exerts negative effects on health related quality of Life (HRQoL). However, the effects of surgery on the postoperative HRQoL in the different endometriosis subgroups have not been fully evaluated.
Methods: We performed a comparative prospective study between 2014 and 2018 at the Medical University of Vienna, including all patients with surgically confirmed endometriosis who had completed the standardized Endometriosis health profile-30 (EHP-30) questionnaire one day after surgery (the questions refer to the four weeks preoperatively) and six to ten weeks postoperatively.
Results: All five categories regarding postoperative conditions showed significant benefits compared to preoperative values: "pain" (HR 0.78, p<0.001); "selfdetermination" (HR 0, 92, p<0.001); "emotional health" (HR 0,83, p<0.001);" social environment" (HR 0,67, p<0.001); and "selfimage" (HR 0,47, p<0,001). In patients with only peritoneal endometriosis were no significant changes in any of the categories. In the subgroups deep infiltrating endometriosis (DIE) and DIE+ovarian endometrioma, surgical intervention results in a significantly greater improvement in all categories of EHP-30 compared to ovarian endometrioma without DIE or peritoneal endometriosis.
Conclusion: Our study shows that especially warnen with DIE with or without ovarian endometrioma demonstrate a more pronounced benefit from surgical therapy compared to patients with peritoneal endometriosis or endometrioma without DIE.