1836 Outcomes of Laparoscopic Management of Chronic Pelvic Pain and Endometriosis

Abstract

Study Objective To analyze the rate of re-operation and pelvic pain outcomes for patients who underwent laparoscopic surgery for chronic pelvic pain and endometriosis. Secondary objectives were to study the impact of surgery on quality of life and fertility outcomes. Design This is a retrospective study and a prospective online or telephone questionnaire of patients who underwent laparoscopic surgery for pelvic pain and/or endometriosis. The 12-Item Short Form Health Survey (SF-12) and the Female Sexual Function Index (FSFI) were used in part to develop the prospective questionnaire. Setting Tertiary care university referral center for minimally invasive gynecologic surgery. Patients or Participants Sixty-nine patients who underwent laparoscopic surgery for chronic pelvic pain. Interventions Retrospective chart review and prospective telephone or internet-based questionnaire. Measurements and Main Results Sixty-nine subjects consented and filled out a comprehensive questionnaire. Mean follow-up time was 28.3 months. Forty-three subjects who completed the questionnaire were visually found to have endometriosis. The rate of reoperation was 8.60% for patients with pathologic confirmation of endometriosis. 23.3% of patients with endometriosis underwent hysterectomy. The rate of re-operation was 9.09% for patients who did not undergo hysterectomy. 67.4% of patients with endometriosis were still pain-free at the time of the survey. The rate of re-operation for those without endometriosis was 0%. 30.2% of patients with endometriosis had a history of infertility for an average of 1.889 years prior to surgery. Following surgery, 83.3% of previously infertile patients with endometriosis attempted to conceive with 80.0% success rate. Subjects had significant improvement in each quality of life measurement and most sexual function indices analyzed. Conclusion Laparoscopic surgery for endometriosis had a low rate of re-operation, and long-term improvement in pelvic pain, sexual function, quality of life and fertility outcomes, with a high satisfaction rate.