Patient satisfaction and changes in pain scores after ablative laparoscopic surgery for stage III-IV endometriosis and endometriotic cysts.
OBJECTIVE
To document the changes in pain scores 3-12 months following ablative laparoscopic surgery. Secondary outcome measures included patient satisfaction scores.


METHODS
A prospective, cohort study.


METHODS
A tertiary referral center for the treatment of endometriosis.


METHODS
Seventy-three consecutive women with stage III-IV endometriosis and an endometrioma >2 cm.


METHODS
A laparoscopy was performed. The extraovarian endometriosis was ablated with a CO(2) laser, and the endometrioma capsule was fenestrated then ablated with the potassium-titanic-phosphate (KTP) laser or the Bicap bipolar diathermy.


METHODS
Pre- and postoperative visual analogue scores for pelvic pain were completed. Patient satisfaction was scored from 1 to 10, with a score of 10 being "most satisfied."


RESULTS
A total of 73 women with stage III-IV endometriosis and 96 cysts (23 cysts were bilateral). The mean revised American Fertility Society (AFS) score was 65.5 (range 22-128). At 12 months, the mean temporal decrease in the pain score for dyspareunia was 2.14 +/- 0.41; for dysmenorrhea, 1.52 +/- 0.38; and for chronic nonmenstrual pain, 2.37 +/- 0.43. Sixty-four (87.7%) patients were satisfied or very satisfied with the treatment. No surgical complications occurred.


CONCLUSIONS
Laparoscopic ablative surgery for endometriomas in the presence of stage III-IV endometriosis is an effective treatment for relieving pelvic pain.
Department of Gynaecology, Royal Surrey County Hospital, Guildford, United Kingdom. kjones@rschguilford.freeserve.co.uk
Kevin D
KD
Jones
Christopher
C
Sutton
D000328:Adult; D015331:Cohort Studies; D003560:Cysts / Q000503:physiopathology / Q000601:surgery*; D004715:Endometriosis / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D010147:Pain Measurement; D017060:Patient Satisfaction; D011446:Prospective Studies