92: Long-term outcomes of laparoscopic surgery for endometriosis

Abstract

To analyze the rate of recurrent pain and reoperation for patients who underwent laparoscopic excision of endometriosis. Secondary objectives were to study the impact of surgery on long-term quality of life and the effect on fertility following laparoscopic excision of endometriosis. This is a retrospective study of patients who underwent laparoscopic surgery for pelvic pain and/or endometriosis at a tertiary care university referral center for minimally invasive gynecologic surgery. A retrospective chart review as well as a prospective online and telephone questionnaire were performed to analyze long term outcomes, pain recurrence, reoperation and fertility outcomes. Quality of life validated questionnaire (SF-12) and the Female Sexual Function Index (FSFI) were used. Two hundred thirty-nine subjects underwent laparoscopic surgery for pelvic pain from July 2010 to June 2015 who were identified from ICD-9 codes representing various pelvic pain symptoms. Sixty-nine subjects consented and filled out a comprehensive questionnaire. Thirty-nine of these subjects had endometriosis confirmed on pathology. Mean follow-up time was 27.13. Of the patients with endometriosis, 84.6% underwent laparoscopic excision, and 7.7% of the patients with endometriosis needed further surgical intervention following the index procedure. Two thirds of the patients with endometriosis (N=26) were still pain-free at the time of the survey. Of those that had recurrence of pain following surgery, they were pain free for an average of 1.958 years before recurrence. One third of the endometriosis patients (N=13) had a history of infertility for an average of 1.889 years prior to surgery. Following surgery, 76.9% of previously infertile patients attempted to conceive with 80% success rate. The endometriosis subjects had significant improvements in each quality of life measurement and most sexual function indices analyzed. Laparoscopic surgery for endometriosis had a low rate of reoperation, and long-term improvement in pelvic pain, sexual function, quality of life and fertility outcomes, with a high satisfaction rate.