Incidence of symptom recurrence after hysterectomy for endometriosis.
OBJECTIVE
To determine the relative risk of symptom recurrence and/or reoperation after hysterectomy with ovarian preservation for the treatment of endometriosis.


METHODS
Historical prospective study of patients with endometriosis who underwent hysterectomy with or without ovarian preservation.


METHODS
One hundred thirty-eight women who underwent hysterectomy with the diagnosis of endometriosis.


METHODS
A computer search identified 138 women who underwent hysterectomy with the diagnosis of endometriosis at Johns Hopkins Hospital from 1979 to 1991. Follow-up information was obtained from medical records, outpatient charts, and telephone surveys.


RESULTS
Twenty-nine women had hysterectomy with some ovarian tissue preserved; 109 had all ovarian tissue removed. Of those with ovarian preservation, 18 of 29 (62%) had recurrent pain and 9 of 29 (31%) required reoperation. Of those who had no ovarian preservation, 11 of 109 (10%) had recurrent symptoms and 4 of 109 (3.7%) required reoperation. Ovarian conservation was associated with a relative risk for pain recurrence of 6.1 (95% confidence interval [CI] 2.5 to 14.6) compared with patients with oophorectomy in a Cox proportional hazards model. The relative risk for reoperation in patients with ovarian conservation was 8.1 (95% CI 2.1 to 31.3).


CONCLUSIONS
Compared with women who had oophorectomy for endometriosis, patients who underwent hysterectomy with ovarian conservation had 6.1 times greater risk of developing recurrent pain and 8.1 times greater risk of reoperation.
Namnoum
A B
AB
Johns Hopkins Hospital, Department of Gynecology and Obstetrics, Baltimore, Maryland 21287-1247, USA.
Hickman
T N
TN
Goodman
S B
SB
Gehlbach
D L
DL
Rock
J A
JA
D000328:Adult; D004715:Endometriosis / Q000150:complications / Q000453:epidemiology* / Q000601:surgery*; D015914:Estrogen Replacement Therapy / Q000009:adverse effects / Q000592:standards; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000592:standards*; D015994:Incidence; D008875:Middle Aged; D015999:Multivariate Analysis; D010052:Ovariectomy; D010053:Ovary / Q000502:physiology / Q000601:surgery; D010146:Pain / Q000453:epidemiology* / Q000209:etiology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D011795:Surveys and Questionnaires