Preoperative pain and recurrence risk in patients with peritoneal endometriosis

Abstract

Objective. Pain symptoms in endometriosis patients do not necessarily correlate with the extent of the disease, and there is little evidence regarding the recurrence risk. Aim of this study was to assess the risk factors for the recurrence of endometriosis, with regard to preoperative and postoperative pain.

Design. Retrospective observational study.

Setting. Single institution study.

Population. A total of 150 patients were followed up for recurrence after surgical treatment for endometriosis.

Methods. The patients were interviewed retrospectively to obtain information about pain levels during the course of the disease.

Main outcome measures. Disease free survival.

Results. High preoperative pain levels were associated with a higher risk of recurrence after 4 years of follow-up. The hazards ratio was 2.30 (95% CI, 1.22–4.31; p = 0.009). None of the other parameters assessed for medical history, reproductive history, or lifestyle was associated with the recurrence risk.

Conclusions. The risk for recurrence after surgery for endometriosis may be substantially influenced by the patients' perception of pain. Risk classifications for the recurrence risk in endometriosis are nonexistent. Developing these is imperatively needed soon to improve further treatment and/or prophylaxis for patients after surgery. A classification might be improved by adding sensory testing before surgery.

Keywords:

• Classification
• recurrence rate
• endometriosis
• pelvic pain
• dysmenorrhoea
• relapse

Acknowledgement

We thank Doris Herbst, Ulrike Müller, and Sara Kellner for their logistic support during the conduction of this study and the patients for their willingness to take part.