Preoperative pain and recurrence risk in patients with peritoneal endometriosis.
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.
Renner
Stefan Peter
SP
Department of Gynaecology and Obstetrics, Erlangen University Hospital, Universitaetsstrasse 21-23, Erlangen, Germany. stefan.renner@uk-erlangen.de
Rix
Susanne
S
Boosz
Alexander
A
Lermann
Johannes Hugo
JH
Strissel
Pamela L
PL
Thiel
Falk Clemens
FC
Oppelt
Peter
P
Beckmann
Matthias W
MW
Fasching
Peter Andreas
PA
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