Health Economic Burden of Deep Infiltrating Endometriosis Surgically Treated in a Referral Center

Abstract

ORIGINAL RESEARCH ARTICLE infertility, suprapubic pain, dysuria, hematuria or repeated urinary infection (10). To date, few studies have been conducted to quantify the specific economic impact of endometriosis in general (11-14). Related symptoms and multiple chronic conditions cause high rates of hospital admissions, advanced surgical procedures, and healthcare-related costs. Several studies compared endometriosis to other chronical diseases such as Parkinson's disease, diabetes, Crohn's disease or migraine. Endometriosis seems to be a comparable (11, 13) or even more costly public health problem (15-18). Surgery is one recommended treatment for symptomatic DIE (9, 19). Compared to superficial endometriosis, DIE takes longer surgery time, a prolonged hospital length-of-stay [LOS], and therefore higher costs (20). Furthermore, highly qualified surgery often causes severe complications (21, 22). Additionally, DIE has a high risk of recurrence (6, 23), but it is difficult after a surgery to determine whether the surgical treatment was incomplete or there is recurrence (24). There is a lack of detailed information on the burden of DIE of the bladder or bowel for the German healthcare system. The primary aim of this study was to assess the related direct costs of surgical treatment of bowel and bladder DIE adopting a hospital's perspective and to describe the characteristics of the study population.