Surgery versus non-surgical treatment for endometriosis-related pain during the COVID-19 pandemic

Abstract

ObjectiveThere are no studies directly comparing medical vs surgical treatments in improving endometriosis-related pain despite the condition’s widespread prevalence. The COVID-19 pandemic restrictions resulted in many endometriosis patients unable to receive surgical treatment, providing an opportunity to compare non-surgical management directly against the conventional practice of surgery. We also explored the impact of the pandemic on the quality of care and quality of life for endometriosis patients. MethodsAn online questionnaire was conducted between June and August 2023. Patients from a single centre were asked to participate if they had received surgery in 2018−2019 or received non-surgical management in 2020−2022. The questionnaire measured impacted endometriosis care, quality of life over the pre-, during, and post-pandemic periods with the endometriosis impact questionnaire (EIQ), and treatment effectiveness with the numerical rating scale (NRS). ResultsOf the 60 total respondents, 56.7% had a cancelled, postponed, or rescheduled clinic appointment, while 33.3% were impacted for endometriosis surgery and 8.3% for fertility treatment. There were no statistically significant differences in EIQ scores during or after the pandemic as compared to before and during for all domains. Both surgery and non-surgical treatment decreased NRS scores significantly by 3, p < 0.001. There was no significant difference between the two treatments, p = 0.901. ConclusionThe quality of life of endometriosis patients remained stable despite disruptions to care during the COVID-19 pandemic. Both surgical and non-surgical treatments are effective for endometriosis-related pain, although how one compares to the other is still unclear due to systematic differences between study cohorts.