Surgery is associated with an increased quality of life in women with endometriosis

1. In adult women with endometriosis, surgery was associated with an increased quality of life independent of their #Enzian classification.

Evidence Rating Level: 2 (Good)

Endometriosis affects 7-10% of women of reproductive age and has a heterogeneous presentation, ranging from superficial peritoneal implants to involvement of retroperitoneal structures. The wide range of symptoms associated with endometriosis has led to the development of various questionnaires and classification systems, such as the Endometriosis Health Profile-30 (EHP-30) and revised American Society for Reproductive Medicine (rASRM) system. #Enzian is a newer classification system based on the location (peritoneal compartment (P), ovarian compartment (O), tubo-ovarian condition (T), rectovaginal septum/uterosacral ligament compartment (B), rectal compartment (C), adenomyosis (FA), bladder involvement (FB), and ureteral involvement (FU)) and size of lesions, and includes scores for deep endometriosis. This study sought to investigate the association between #Enzian scores and quality of life after surgery. Women aged 18-50 years undergoing surgery for suspected endometriosis were prospectively recruited and included in the final analysis if endometriosis was confirmed by histopathological examination. 627 women (median [IQR] age, 32 [28-36] years) were included in the final cohort, with 430 and 325 completing the 6-month and 12-month follow-ups, respectively. The most frequently involved #Enzian compartments were P (86%), B (45%), and FA (42%). Compared with baseline, median EHP-30 scores decreased markedly at both 6 months (median 34.4, p < 0.001) and 12 months (median 31.1, p < 0.001). No significant difference was observed between 6 and 12 months. None of the #Enzian compartment locations significantly predicted EHP-30 scores at baseline, 6 months, or 12 months, with the exception of FB involvement and baseline EHP-30 score (p = 0.024). The article notes only 24 (3.83%) patients had 24 involvement. Baseline EHP-30 score (p < 0.001) and complete resection (p = 0.001) significantly predicted EHP-30 score at 6 months.

Click here to read this study in BMC Medicine

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