Endometriosis-related pelvic pain following laparoscopic surgical treatment

Abstract

Introduction: Endometriosis is a common, often-debilitating disease, affecting women of reproductive age. Pain is a common symptom of the disease and is commonly treated by surgery, medical therapy, or a combination of the two. This study aimed to evaluate the rates of ongoing pain post laparoscopic excision and the risk factors for ongoing pain symptoms. Methods: This retrospective cohort study analyzed the medical records of all patients who underwent laparoscopic surgery for endometriosis in a large tertiary healthcare service in Australia between January 2009 and September 2016. Results were analyzed using SPSS statistics version 11. Results: A total of 972 patients met the inclusion criteria; of these, 398 had follow-up at our hospital network and were included in the final analysis. The median age was 34.5 years, 69.6% were of Caucasian ethnicity, and the median body mass index was 25.9; 70.6% of our patients reported decreased pain after surgery. Patients who suffered from chronic pain were twice as likely to experience ongoing pain, while patients with stage 3–4 endometriosis were found to have 65% reduced odds of pain at follow-up (95% confidence interval = 0.22–0.61, p < 0.001). In univariate analysis of non-Caucasian patients, those who had a specialist endometriosis surgeon perform the surgery had significantly higher incidence of symptom improvement (58% reduced odds of recurrent pain and 40% reduced odds, p < 0.05, accordingly). Conclusion: The prevalence and severity of pain associated with endometriosis mandates a thorough understanding of the effectiveness of current management. Our article highlights the utility of laparoscopic surgery in treating endometriosis-associated pain.

Comparison of laparoscopic cystectomy and fenestration/cauterization procedures in terms of pelvic pain and recurrence in patients with endometrioma

“…It has been shown that patients visit a doctor's office an average of 10 times before receiving the diagnosis [14]. Endometriosis can be efficiently treated with both pharmacological and surgical approaches [15,16]. The advancement and widespread use of laparoscopic technology is pushing the boundaries of endometriosis surgery, and it is currently suggested to prefer laparoscopy to open surgery for endometrioma surgery [17].…”

Systematic review of patient-specific pre-operative predictors of pain improvement to endometriosis surgery

“…A retrospective cohort study by Harris (Harris et al, 2020) recruited 972 women who underwent 304 therapeutic laparoscopy for confirmed endometriosis. In total 398 women had complete 305 follow-up reported 6/52 weeks post-operatively.…”

Evaluation of laparoscopy results for the patients with chronic pelvic pain

“…The complexity of the variety of pelvic pain causes these patients not to receive a definitive diagnosis in more than 60% of cases, and this point is especially evident in the case of musculoskeletal factors (5)(6)(7). The prevalence of this pain in different societies, according to the characteristics of the studied society and the method of conducting the study, has been reported to be between 8.3-39% (7,8). Diagnosing and treating CPPS accounts for 10% of visits to obstetricians and gynecologists, 20% of all laparoscopies, and 12-16 hysterectomies, which in the United States cost over $2.8 billion per year (5).…”

“…Diagnosing and treating CPPS accounts for 10% of visits to obstetricians and gynecologists, 20% of all laparoscopies, and 12-16 hysterectomies, which in the United States cost over $2.8 billion per year (5). According to an estimate (8), 158 million pounds are spent annually on diagnosing and treating this condition in the British National Health Service. This pain affects women's daily activities and quality of life and negatively affects their mental and physical health (8,9).…”

“…According to an estimate (8), 158 million pounds are spent annually on diagnosing and treating this condition in the British National Health Service. This pain affects women's daily activities and quality of life and negatively affects their mental and physical health (8,9). Mak et al (10) reported the prevalence of CPPS as 39% in a hospital-based study of 559 people.…”