Surgical treatment of endometriosis: prognostic factors for better quality of life

Abstract

The present study investigated the effect of surgical treatment of endometriosis on physical and mental health. We undertook a prospective survey including 153 premenopausal women with histological diagnosis of endometriosis. The Short Form 12 (SF-12) questionnaire comprising physical and mental component scales was used. Two groups of patients were distinguished: Group A (n = 42) with SF-12 scores above the median in both physical and mental scales; Group B (n = 111) with SF-12 scores below the median in either physical or mental scale. Group A was diagnosed and operated for endometriosis for the first time at an older age (30 vs. 26 years), had undergone more frequently a single surgical intervention (64% vs. 46%), was less affected by symptom or lesion recurrence and had reported less intense current pain symptoms than Group B. Having the first endometriosis surgery at a later age was an independent predictor of better health status (adjusted odds ratio 1.146 per year, 95% confidence interval 1.058–1.242) after accounting for the potential confounding effects of reoperation, pelvic pain and time elapsed since the first surgery. In conclusion, patients with endometriosis who had a single surgery at an older age have good symptom control and better quality of life (QoL).

摘要

本研究调查了子宫内膜异位症的手术治疗对身心健康的影响。我们进行了一项前瞻性调查, 包括了153名经组织学诊断为子宫内膜异位的绝经前妇女。应用包括身体和精神因素评分的简表12问卷（SF-12）进行评价。所有患者被分为2组：A组（n=42）, SF-12简表在身体和精神方面的评分都高于中位数；B组（n=111）, SF-12简表在身体和精神方面的评分都低于中位数。A组在年龄较大时（30岁对比26岁）首次被诊断为子宫内膜异位症并进行手术, 接受单次手术干预的比例更高（64％对比46％）, 受症状或病变复发的影响较小, 并且当前疼痛症状较B组少。在排除再次手术、盆腔疼痛和第一次手术后的时间这些潜在的混杂因素后, 第一次子宫内膜异位症手术年龄较晚是健康状况较好的独立预测因子(调整后OR值1.146每年, 95%置信区间1.058-1.242)。综上所述, 子宫内膜异位症患者年龄越大, 单次手术的症状控制越好, 生活质量(QoL)也越好。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• Endometriosis
• surgery
• physical health
• mental health
• SF-12
• quality of life
• recurrence
• pain

Disclosure statement

No potential conflict of interest was reported by the authors.