Treatment Patterns, Complications, and Health Care Utilization Among Endometriosis Patients Undergoing a Laparoscopy or a Hysterectomy: A Retrospective Claims Analysis

Eric S Surrey, Ahmed M Soliman, Hongbo Yang, Ella X. Du, Ella Xiaoyan Du, Bowdoin Su
Advances in therapy · 2017 · vol. 34(11) , pp. 2436–2451 · doi:10.1007/s12325-017-0619-3 · PMID:29039055 · PMC5702365 · W2766690916
article OA: gold CC0 ⤵ 25 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This retrospective claims analysis compared 1-year post-surgical outcomes for endometriosis patients and found differences in medication use, complication rates, and hospitalizations between those who underwent laparoscopy versus hysterectomy.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 ⓘ

This retrospective claims analysis used Truven MarketScan data (2004–2013) to study women aged 18–49 with an endometriosis diagnosis who underwent either an endometriosis-related laparoscopy or an endometriosis-related hysterectomy, comparing 1-year post–index-surgery treatment patterns, complications, and health care utilization. Among 24,915 hysterectomy and 37,308 laparoscopy patients with continuous insurance and no uterine fibroid diagnosis at/ before the index date, those receiving laparoscopy were more likely to be prescribed GnRH agonists, progestins, danazol, and opioid analgesics shortly after surgery, whereas hysterectomy patients generally had higher complication rates, with higher index hospitalization rates and longer length of stay, and laparoscopy patients showing higher post-index hospitalization and length of stay. Across both cohorts, post-procedure complications were associated with significantly higher hospitalization rates and longer length of stay. The authors note a major limitation of the descriptive, claims-based approach (no direct clinical detail beyond coded events) and an observational design comparing procedure groups without randomization. This paper is centrally about endometriosis — it compares post-surgical complications and health care utilization after laparoscopy versus hysterectomy in endometriosis patients.

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Abstract

INTRODUCTION: Hysterectomy and laparoscopy are common surgical procedures used for the treatment of endometriosis. This study compares outcomes for women who received either procedure within the first year post initial surgery. METHODS: The study used data from the Truven Health MarketScan claims databases from 2004 to 2013 to identify women aged 18-49 years who received an endometriosis-related laparoscopy or hysterectomy. Patients were excluded if they did not have continuous insurance coverage from 1 year before through 1 year after their endometriosis-related procedure, if they were diagnosed with uterine fibroids prior to or on the date of surgery (i.e., index date), or if they had a hysterectomy prior to the index date. The descriptive analyses examined differences between patients with an endometriosis-related laparoscopy or hysterectomy in regard to medications prescribed, complications, and hospitalizations during the immediate year post procedure. RESULTS: The final sample consisted of 24,915 women who underwent a hysterectomy and 37,308 who underwent a laparoscopy. Results revealed significant differences between the cohorts, with women who received a laparoscopy more likely to be prescribed a GnRH agonist, progestin, danazol, or an opioid analgesic in the immediate year post procedure compared to women who underwent a hysterectomy. In contrast, women who underwent a hysterectomy generally had higher complication rates. Index hospitalization rates and length of stay (LOS) were higher for women who had a hysterectomy, while post-index hospitalization rates and LOS were higher for women who had a laparoscopy. For both cohorts, post-procedure complications were associated with significantly higher hospitalization rates and longer LOS. CONCLUSION: This study indicated significantly different 1-year post-surgical outcomes for patients who underwent an endometriosis-related hysterectomy relative to a laparoscopy. Furthermore, the endometriosis patients in this analysis had a considerable risk of surgical complications, subsequent surgeries, and hospital admissions, both during and after their initial therapeutic laparoscopy or hysterectomy. FUNDING: AbbVie.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Health Resources Hysterectomy Laparoscopy Postoperative Complications Adolescent Adult Endometriosis Female Health Resources Hospitalization Hospitalization Humans Hysterectomy Hysterectomy Insurance Claim Review Laparoscopy Laparoscopy Length of Stay Length of Stay

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