Vergleich einer Endometriose-Spezialambulanz mit einer Universal-Präop-Ambulanz gemessen an der Rate an primär-sanierten Endometriose-Operationen

Background: Endometriosis presents with a very variable symptomatology and the diagnosis is often very complex. Therapy is multidisciplinary, and surgical resection of the endometriotic lesions is considered if symptoms persist. The aim of this retrospective cohort study is to compare an outpatient clinic specialized on endometriosis patients with a universal preoperative outpatient clinic in terms of care of endometriosis patients and surgical outcome. \nMethods: The women selected to participate in this retrospective study were those who underwent their first scheduled surgery for endometriosis in 2018 at the Department of Gynecology at Kepler University Hospital and who had previously undergone a preoperative examination at the same university hospital. The main outcome parameter was the R0 resection rate in both groups. \nResults: Of the 199 women included in the study, 121 were examined in the universal and 78 in the specialized outpatient clinic. Overall, no relevant difference in the R0 resection rate was observed (80.0% vs. 80.5%, p=0.929). A clear tendency towards a higher detection rate in the endometriosis outpatient clinic was seen in the preoperative diagnosis of deep endometriosis (53.3% vs. 36.9%, p=0.088) and endometriomas (89.3% vs. 70.2%, p=0.086), but without statistical significance. However, highly significant differences were detected in the comparison of rates of rectal palpation performed (98.7% in the special outpatient clinic vs. 50.4% in the universal outpatient clinic, p<0.001) and in the rate of kidney sonography performed pre-operatively (93.6% vs. 10.0%, p<0.001). \nConclusions: In an outpatient clinic specialized on endometriosis patients, diagnostic measures recommended in international guidelines, such as rectal palpation and renal sonography, are performed significantly more frequently with a trend towards better non- invasive detection of deep endometriotic lesions.