Introduction
Endometriosis is a common gynaecological condition with a high burden on the patient’s quality of life due to the chronic pain and recurrence of disease. By studying a Melbourne cohort of endometriosis patients, our goal was to determine the incidence of repeat surgery, and to identify what interventions are performed on these women.
Methods
De-identified clinical questionnaires were obtained through the Royal Women’s Hospital with consent. Questionnaires contained data including demographics, diagnosis, disease severity, and other medically relevant information. For women with surgical diagnosis of endometriosis (visually confirmed at surgery), we identified those who later returned for another surgery related to endometriosis, and further analyzed their data from surgical, medical, and pathological reports.
Results
From 2011 to 2017, we had a cohort of 420 patients with surgically diagnosed endometriosis. The mean age at initial operation was 30.48 (SD6.96). Of those with endometriosis, 23.3% (n=98) had further surgeries for endometriosis. The majority of patients had two surgeries in total (n=73), with a mean time to repeat surgery of 136 weeks.
Of all patients with endometriosis, 6.4% (n=27) had hysterectomies at some point, with 62.9% (n=17) of those at the second surgery. In terms of other procedures, 41.0% (n=172) patients had adhesions surgically divided, 36.4% (n=153) had cystectomies including ablation of endometriomas, 5.5% (n=23) had oophorectomies, and 13.1% (n=55) had salpingectomies.
Conclusion
Our study demonstrated that a significant number of patients with surgically diagnosed endometriosis return for repeat surgeries, with many requiring procedures such as hysterectomies and adhesiolysis. We determined a mean time to repeat surgery of 136 weeks. Further work is required to identify possible clinical risk factors for disease recurrence. Currently, the information generated from this cohort is beneficial to understanding the clinical indication(s) of repeat surgery for endometriosis and has implications for the surgical management of these patients.