No Regrets: Surgical Decision Regret in Women Pursuing Surgery for Endometriosis or Chronic Pelvic Pain

Abstract

Study Objective identify incidence of decision regret associated with surgery for endometriosis or pelvic pain. Design survey study. Setting academic medical center. Patients or Participants all patie.nts who underwent surgery for endometriosis or chronic pelvic pain (CPP) from January 2016 to June 2019 Interventions Questionnaire. Measurements and Main Results 253 patients were contacted to complete a survey consisting of two validated questionnaires: the decision regret scale (DRS) and the patient global impression of improvement (PGI-I). 154 patients responded (60.8% response rate). 137 women (90%) agreed or strongly agreed that having surgery for endometriosis or CPP was the right decision. 134 women (87%) indicated they would choose to have surgery again. On the PGI-I scale, 96 women (62.7%) reported feeling very much better or much better than before surgery. Survey responders did not differ from non-responders in age (years, 33.9 vs 35, p=0.25), robotic route of surgery (83.1% vs. 78.8%, p=0.66), or performance of hysterectomy (27.3% vs. 26.3%, p=0.85). Responders were more likely to have stage III/IV endometriosis (50.6% vs. 29.3% p Overall, 25 patients (16.3%) reported some level of regret after surgery for endometriosis or CPP. Regret was not associated with lower PGI-I score (OR: 4.37, CI: 0.81-23.7), age (OR: 0.98, CI 0.93-1.04), time since surgery (OR: 1, CI: 0.97-1.04), number of previous surgeries (OR: 1.08, CI: 0.9-1.31), pathology negative for endometriosis (OR 2.82, CI 0.95-8.32), hysterectomy (OR: 0.82, CI: 0.30-2.21), or complications (OR: 1.07, CI: 0.22-5.16). Conclusion Most women who pursue surgery for endometriosis or CPP are satisfied with their decision. Regret was not associated with lower PGI-I score, negative pathology for endometriosis, performance of hysterectomy, or complications. Gynecologic surgeons should engage in shared decision-making with patients considering surgery for endometriosis or CPP.