Preoperative pain and recurrence risk in patients with peritoneal endometriosis

Stefan Peter Renner, Stefan P. Renner, Susanne Rix, Alexander Boosz, Johannes Hugo Lermann, Johannes Lermann, Pamela L Strissel, Falk Clemens Thiel, Falk C. Thiel, Peter Oppelt, Matthias W Beckmann, Peter A. Fasching, Peter Andreas Fasching
Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology · 2009 · vol. 26(3) , pp. 1–6 · doi:10.1080/09513590903159623 · PMID:19718567 · W2041705606
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

High preoperative pain levels correlated with a 2.30-fold increased risk of endometriosis recurrence after four years, while other patient factors did not.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

The paper investigated how patients’ preoperative pain levels relate to the risk of symptom recurrence in individuals with peritoneal endometriosis, using a high-level clinical/observational approach that connected baseline pain measures to later recurrence outcomes. It found that preoperative pain is associated with recurrence risk after surgery, indicating that pain experienced before the procedure carries prognostic information. A key limitation is that the reported associations may depend on how pain and recurrence were defined and measured within the study design. This paper is centrally about endometriosis — it specifically examines peritoneal endometriosis and links preoperative pain to recurrence risk.

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Abstract

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. DESIGN: Retrospective observational study. SETTING: Single institution study. POPULATION: 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. MAIN OUTCOME MEASURES: 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.

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Condition tags

endometriosischronic_pelvic_pain

MeSH descriptors

Endometriosis Pelvic Pain Peritoneal Diseases Adult Cohort Studies Disease-Free Survival Endometriosis Endometriosis Female Humans Kaplan-Meier Estimate Pelvic Pain Pelvic Pain Peritoneal Diseases Peritoneal Diseases Proportional Hazards Models Recurrence Retrospective Studies Risk Factors

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