Women with Endometriosis Undergoing Surgery Often Require Further Treatment

Recurrence of endometriosis is common even in women who underwent surgery, a new study confirmed. This suggests that women with endometriosis should be closely followed up even after treatment with surgery.

Recurrence of endometriosis is common even in women who underwent surgery, a new study confirmed. This suggests that women with endometriosis should be closely followed up even after treatment with surgery.

For the study published online in the Journal of Women's Health, the authors “mined” the Truven Health Market Scan claims database, a real-world database for healthcare research and analytics, to anonymously identify women with endometriosis who underwent surgery and whose medical records were available for a period of at least ten years (from 2004 to 2013).  

In the database, the researchers identified 24,915 women who underwent hysterectomy and 37,308 women who underwent laparoscopy. They then calculated the percentage of women who required surgery a second time, up to eight years after the initial surgery, and compared the risk of re-treatment between women who originally underwent hysterectomy and those who originally underwent laparoscopy.

They found that women who underwent hysterectomy were re-treated 3.3%, 4.7%, and 5.4% of the time in the second, fifth, and eighth year following surgery. For women who underwent laparoscopy these rates were even higher, with 15.8%, 27.5%, and 35.2%, of them undergoing a second surgery in the second, fifth, and eighth year respectively.

Based on these figures, the authors calculated that a woman who initially underwent laparoscopy is about six times more likely to require further surgery than a woman who initially underwent hysterectomy.

However, if the definition of re-treatment was expanded to include medical treatments other than surgery, the rate of re-treatment was 11 to 14 times higher in women who underwent hysterectomy and two to four times higher in those who underwent laparoscopy, In other words, under a more general definition of re-treatment, a woman who initially underwent laparoscopy was twice as likely to require further treatment, as a woman who underwent hysterectomy.

Hysterectomy, or the removal of the womb, and laparoscopy, a less invasive surgical procedure to remove tissues or organs from the pelvis or abdomen are two types of surgery commonly offered to women with endometriosis. This study shows that re-treatment is often required after laparoscopy and that hysterectomy also does not always guarantee a complete cure.

However patients should realize that abovementioned two types of treatment, namely hysterectomy or laparoscopy are not alternative to each other and decision for patient selection for surgery and the modality of surgery are individualized based on many patient-related parameters.

Research Source: http://online.liebertpub.com/doi/10.1089/jwh.2016.6043