LONG-TERM OUTCOMES OF PHARMACOLOGICAL VERSUS SURGICAL TREATMENT IN WOMEN WITH ENDOMETRIOSIS: IMPACT ON RECURRENCE AND QUALITY OF LIFE — A REVIEW ARTICLE

Endometriosis is a chronic inflammatory estrogen-dependent disease affecting approximately 10% of women of reproductive age. Although there have been significant advancements in diagnosis and management, the recurrence and sustained impaired quality of life (QoL) constitute a serious challenge for clinical care. Treatments aim at pharmacological inhibition and surgical excision, but long-term comparative outcomes are controversial.

To assess long-term outcomes of pharmacological versus surgical treatment in endometriosis treatment in women, including recurrence, duration of pain control, quality of life.

A systematic review of open-access peer-reviewed studies published from 2006 to 2026 was performed, using PubMed Central, BMC, PLOS and other open-access databases. The inclusion criteria included randomized controlled trials (RCTs), systematic reviews, meta-analyses, and large cohort studies with ≥12 month follow-up. The included studies included were made up of thirty-five eligible studies.

Surgical treatment is associated with short-term symptom relief and a 5-year recurrence rate of 20–50%. Drug interventions (COCs, progestins, GnRH analogues/antagonists) provide analgesia but have a high recurrence rate on discontinuation. The incidence of the recurrence is markedly decreased as a result of combined postoperative hormonal treatment. QoL is improved in both modalities; sustained benefit associated with recurrence prevention and improved QoL is evident in each modality.

There is no absolute cure for either modality alone. There is an indication for personalized interventions with treatment and individualized approach, surgical and long-term hormonal suppression leading to the most durable results in patients.

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