title: Preoperative pain and recurrence risk in patients with peritoneal endometriosis.
abstract: OBJECTIVE
  Pain symptoms in endometriosis patients do not necessarily correlate with the extent of the disease, and there is little evidence regarding the recurrence risk. Aim of this study was to assess the risk factors for the recurrence of endometriosis, with regard to preoperative and postoperative pain.
  
  
  METHODS
  Retrospective observational study.
  
  
  METHODS
  Single institution study.
  
  
  METHODS
  A total of 150 patients were followed up for recurrence after surgical treatment for endometriosis.
  
  
  METHODS
  The patients were interviewed retrospectively to obtain information about pain levels during the course of the disease.
  
  
  METHODS
  Disease free survival.
  
  
  RESULTS
  High preoperative pain levels were associated with a higher risk of recurrence after 4 years of follow-up. The hazards ratio was 2.30 (95% CI, 1.22-4.31; p = 0.009). None of the other parameters assessed for medical history, reproductive history, or lifestyle was associated with the recurrence risk.
  
  
  CONCLUSIONS
  The risk for recurrence after surgery for endometriosis may be substantially influenced by the patients' perception of pain. Risk classifications for the recurrence risk in endometriosis are nonexistent. Developing these is imperatively needed soon to improve further treatment and/or prophylaxis for patients after surgery. A classification might be improved by adding sensory testing before surgery.
authors.affiliation: Department of Gynaecology and Obstetrics, Erlangen University Hospital, Universitaetsstrasse 21-23, Erlangen, Germany. stefan.renner@uk-erlangen.de
authors.forename: Stefan Peter
authors.initials: SP
authors.lastname: Renner
authors.forename: Susanne
authors.initials: S
authors.lastname: Rix
authors.forename: Alexander
authors.initials: A
authors.lastname: Boosz
authors.forename: Johannes Hugo
authors.initials: JH
authors.lastname: Lermann
authors.forename: Pamela L
authors.initials: PL
authors.lastname: Strissel
authors.forename: Falk Clemens
authors.initials: FC
authors.lastname: Thiel
authors.forename: Peter
authors.initials: P
authors.lastname: Oppelt
authors.forename: Matthias W
authors.initials: MW
authors.lastname: Beckmann
authors.forename: Peter Andreas
authors.initials: PA
authors.lastname: Fasching
mesh_terms: D000328:Adult; D015331:Cohort Studies; D018572:Disease-Free Survival; D004715:Endometriosis / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D017699:Pelvic Pain / Q000473:pathology* / Q000601:surgery; D010532:Peritoneal Diseases / Q000473:pathology* / Q000601:surgery; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors