Outcomes Following Surgery As the Main Intervention for Endometriosis in a Low Socioeconomic Setting

BACKGROUND AND OBJECTIVE: To evaluate the perioperative and long-term outcomes of surgical management of patients with endometriosis at a community hospital in a low socioeconomic district. METHODS: A total of 39 patients underwent surgical management for endometriosis between October 2022 and November 2024. Thirty-six patients were followed up for 1-24 months. RESULTS: Among the 39 cases, 18 (42.6%) were identified incidentally in operations for other indications, while 21 (53.8%) were clinically diagnosed or confirmed with previous laparoscopy. Twelve (30.8%) cases were classified as stage I-II and 27 (69.2%) as stage III-IV. Surgical approaches included laparoscopy in 23 (59.0%) cases, robotic assistance in 13 (33.3%), and 2 cases were converted from laparoscopy to laparotomy. Advanced techniques utilized included ureterolysis, enterolysis, diaphragm resection, bowel shaving, bowel disc resection, segmental bowel resection, appendectomy, partial bladder cystectomy, and hypogastric nerve sparing. Intraoperative complications included 1 ureteral thermal injury and 1 bladder laceration. Postoperative complications consisted of 1 pyelonephritis and 1 incisional cellulitis. No complications related to urinary or bowel functional disorders occurred postoperatively. Among the 19 patients who regularly used pain medication before surgery, 16 patients discontinued pain medications, while 3 patients reduced their usage after surgery. Eight patients are actively trying to conceive, and 1 patient conceived spontaneously. Sixteen patients are receiving various forms of hormonal suppression. CONCLUSION: With excellent skills and collaboration, the surgical management of endometriosis resulted in minimal complications and optimal postoperative outcomes, significantly benefiting patients in low socioeconomic areas.