Präoperativer Schmerz als Prädiktor des Rezidivrisikos bei Patientinnen mit Endometriose

1.1 Background Endometriosis is one of the most common benign gynecological diseases of women in their reproductive age. The anatomic extent of endometriosis correlates with neither with the intensity of pain nor the risk of recurrence. Due to the partially intense side effects of preventional medication, it seems necessary to select women with an increased risk of recurrence. Objective of this study was, to identify risk factors for recurrence of endometriosis, especially focusing on pain before and after surgical treatment. 1.2 Methods This was a retrospective oberservational study. A total of 150 patients with his-tologic or macroscopic confirmed endometriosis were followed up for recurrence. The patients were interviewed retrospectively to obtain information about pain lev-els before operation, 3 months after operation and were followed up to 3.1 years in average. Main focus was the recurrence free survival, defined as a pain-free sur-vival. 1.3 Results The intensity of preoperative pain has a significant influence to the probability of a recurrence, which is defined as a new incidence of strong pain. The hazards ratio was 2,30 (95% CI, 1,22-4,31; p=0,009). No other parameters assessed in medical history, reproductive history or lifestyle was associated with this risk of recurrence. 1.4 Conclusion After surgery the risk of recurrence of endometriosis is significantly influenced by the patients’ preoperative perception of pain and the extent of its reduction. None of the current classifications includes neither pain nor the risk of recurrence. The development of such a classification in needed to improve further treatment and prophylaxis plans after surgery.