Endometriosis-related pelvic pain following laparoscopic surgical treatment

被引:2
作者
Harris, Amani [1 ]
McCaughey, Tristan [1 ,2 ]
Tsaltas, Jim [1 ,3 ]
Davies-Tuck, Miranda [4 ]
Ratner, Roni [1 ]
Najjar, Haider [1 ,3 ]
Barel, Oshri [5 ,6 ]
机构
[1] Monash Hlth & Monash Univ, Gynaecol Endoscopy & Endometriosis Surg Unit, Melbourne, Vic, Australia
[2] Royal Womens Hosp, Melbourne, Vic, Australia
[3] Melbourne IVF, Melbourne, Vic, Australia
[4] Hudson Inst Med Res, Ritchie Ctr, Melbourne, Vic, Australia
[5] Ben Gurion Univ Negev, Assuta Med Ctr, Obstet & Gynecol, Ashdod, Israel
[6] Assuta Ashdod Univ Hosp, Harefuah 7, IL-7747629 Ashdod, Israel
关键词
Endometriosis; laparoscopic; pain; STAGE-III-IV; CONSERVATIVE SURGERY; OVARIAN ENDOMETRIOMA; LASER LAPAROSCOPY; CONTROLLED-TRIAL; RECURRENCE RATE; EXCISION; MODERATE; WOMEN; PREVALENCE;
D O I
10.1177/2284026520926038
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Introduction: Endometriosis is a common, often-debilitating disease, affecting women of reproductive age. Pain is a common symptom of the disease and is commonly treated by surgery, medical therapy, or a combination of the two. This study aimed to evaluate the rates of ongoing pain post laparoscopic excision and the risk factors for ongoing pain symptoms. Methods: This retrospective cohort study analyzed the medical records of all patients who underwent laparoscopic surgery for endometriosis in a large tertiary healthcare service in Australia between January 2009 and September 2016. Results were analyzed using SPSS statistics version 11. Results: A total of 972 patients met the inclusion criteria; of these, 398 had follow-up at our hospital network and were included in the final analysis. The median age was 34.5 years, 69.6% were of Caucasian ethnicity, and the median body mass index was 25.9; 70.6% of our patients reported decreased pain after surgery. Patients who suffered from chronic pain were twice as likely to experience ongoing pain, while patients with stage 3-4 endometriosis were found to have 65% reduced odds of pain at follow-up (95% confidence interval = 0.22-0.61, p < 0.001). In univariate analysis of non-Caucasian patients, those who had a specialist endometriosis surgeon perform the surgery had significantly higher incidence of symptom improvement (58% reduced odds of recurrent pain and 40% reduced odds, p < 0.05, accordingly). Conclusion: The prevalence and severity of pain associated with endometriosis mandates a thorough understanding of the effectiveness of current management. Our article highlights the utility of laparoscopic surgery in treating endometriosis-associated pain.
引用
收藏
页码:151 / 157
页数:7
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