Reproductive capacity and recurrence of disease after surgery for moderate and severe endometriosis – a retrospective single center analysis

Cordula Schippert, Yvonne Witte, Janina Bartels, Guillermo-José Garcia-Rocha, Matthias Jentschke, Peter Hillemanns, Sudip Kundu
BMC women's health · 2020 · vol. 20(1) , pp. 144 · doi:10.1186/s12905-020-01016-3 · PMID:32660473 · PMC7358195 · W3041381842
article OA: gold CC0 ⤵ 17 in-corpus citations
📄 Open PDF View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study analyzed 206 patients with stage III/IV endometriosis, finding a 21.8% recurrence rate, 93.2% symptom relief, and a 65.8% pregnancy rate in those desiring children.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 ⓘ

This retrospective single-center study evaluated postoperative symptom relief, recurrence, and pregnancy outcomes among 206 premenopausal women who underwent surgery for histologically confirmed rASRM stage III/IV endometriosis between 2004 and 2014, using hospital records and a mailed questionnaire about outcomes. Complete resection was reported in 90.8% of patients, 93.2% reported complete or partial complaint relief, recurrence occurred in 21.8%, and among those desiring children 65.8% became pregnant; age <35 was associated with higher recurrence risk and higher pregnancy rates, and laparoscopic access showed an association with higher postoperative pregnancy rates in their analyses. The authors relied on questionnaire response from 45.2% of eligible patients, which is a key limitation for potential response bias, and recurrence and pregnancy were assessed retrospectively after surgery. This paper is centrally about endometriosis — it analyzes reproductive capacity (pregnancy) and disease recurrence after surgical resection of moderate and severe endometriosis.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Abstract

BACKGROUND: Endometriosis can be associated with considerable pain and sterility. After surgical excision of moderate or severe endometriosis lesions, the rate of recurrence reaches up to 67%. The objective of this retrospective study was to establish the recurrence and pregnancy rates following surgical resection of stage III/IV endometriosis lesions. Indications for operation were endometriosis symptoms, sonographic findings and/or infertility. METHODS: A total of 456 patients who underwent stage III/IV endometriosis surgery between 2004 and 2014 were sent a questionnaire relating to their postoperative medical treatment, pregnancies, relief of symptoms and recurrence. Responses of 206 patients (45.2%) and their clinical data were analysed for this study. RESULTS: A total of 66.5% (N = 137) of patients had stage III disease, and 33.5% (N = 69) had stage IV disease. The average age was 37 years (17-59). A total of 63.1% (N = 130) of surgeries were performed by laparoscopy, 21.8% (N = 45) were performed by laparotomy and 15% (N = 31) were performed by conversion. Complete resection of endometriosis lesions was achieved in 90.8% of patients (N = 187). After surgery, 48.5% (N = 100) of the women did not receive hormonal treatment; the main reason was the desire for children in 53%. Complete or partial relief in complaints was achieved in 93.2% (N = 192). The rate of recurrence was 21.8% (N = 45). The statistically significant factors that was associated with a higher risk to develop recurrence was an age < 35 (p < 0.005). After surgery, 65.8% (79/120) of patients who wished to have children became pregnant. There was a statistically significant association among a higher postoperative pregnancy rate and age < 35 (p < 0.003) in multivariate logistic regression analysis and laparoscopic surgical access in univariate logistic regression analysis (p < 0.01). CONCLUSION: We assessed the high percentage of complete or partial relief of symptoms of 93.2%, the high postoperative pregnancy rate of 65.8% and the low rate of recurrence of 21.8% compared to international literature to be very encouraging for women suffering from moderate and severe endometriosis. Though laparoscopy is considered the 'gold standard'of endometriosis surgery, laparotomy still may be indicated in patients with extensive endometriosis especially to preserve reproductive function.

My notes (saved in your browser only)

Condition tags

endometriosisinfertility

MeSH descriptors

Endometriosis Infertility, Female Laparoscopy Pregnancy Rate Adolescent Adult Endometriosis Endometriosis Female Fertility Fertility Humans Infertility, Female Infertility, Female Middle Aged Pregnancy Pregnancy Outcome Recurrence Reproduction Retrospective Studies

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (59)

Cited by (17)

Source provenance

europepmc
last seen: 2026-06-24T06:10:11.469335+00:00
openalex
last seen: 2026-06-10T17:14:06.276822+00:00
pubmed
last seen: 2026-05-13T22:21:53.586419+00:00
License: CC0 · commercial use OK