Certification of a Rural Endometriosis Clinic Leads to Improvement in the Diagnosis and Treatment of Endometriosis – a Retrospective Analysis

Cynthia Kohl, Jana Kager, Joost Kager, R Donutiu, Raul Donutiu, Michael Gerken, Thomas Papathemelis
Geburtshilfe und Frauenheilkunde · 2025 · vol. 85(09) , pp. 941–950 · doi:10.1055/a-2593-0666 · PMID:40904340 · PMC12404788 · W4410487672
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Certification of a rural endometriosis clinic improved diagnostic accuracy, ultrasound utilization, complete lesion removal rates, and postoperative follow-up assessments.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This single-center retrospective study evaluated whether achieving EuroEndoCert certification in 2019 improved diagnostic and treatment quality for all endometriosis patients who underwent surgery at the clinic between 2018 and 2022. After certification (812 surgeries total across the period), ultrasound utilization increased, adenomyosis was recognized more often, complete removal of lesions rose, and follow-up assessments became more consistent; pain relief at 12 months also increased numerically, and documentation of rectal lesions in patients with dyschezia improved. The authors report several measurable improvements in care processes and outcomes, while acknowledging that challenges remained. This paper is centrally about endometriosis — it assesses how EuroEndoCert certification of a rural endometriosis clinic changed diagnosis and surgical management, including increased recognition of adenomyosis.

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Abstract

Introduction: Endometriosis is a very common benign condition in women. In recent years certification of health care institutions has led to a more standardized care for endometriosis patients, aiming at improving the quality of diagnosis and treatment. The introduction of a common classification system facilitates quantification of disease extent. This study investigated whether certification of a rural endometriosis clinic ameliorated care in endometriosis patients. Methods and Material: A single-center retrospective data analysis was performed of all endometriosis patients that underwent surgery at the investigated institution, certified in 2019, for the years 2018-2022. Results: Between 2018 and 2022, a total of 812 surgeries were performed, with certification significantly improving diagnostic and surgical outcomes. Post-certification, there was an increase in ultrasound utilization (47.7% vs. 35.6%, p = 0.007), greater recognition of adenomyosis (65.8% vs. 57.0%, p = 0.035), and higher rates of complete lesion removal (92.5% vs. 87.8%, p = 0.011). Pain outcomes also improved, with more patients achieving pain relief 12 months postoperatively (40.5% vs. 34.5%, p = 0.196 vs. < 0.001). Additionally, certification enhanced follow-up assessments (64.1% vs. 40.7%, p < 0.001) and documentation of rectal lesions in patients with dyschezia (p < 0.001), indicating a positive impact on overall care quality. Conclusion: This study shows that certification significantly improved care for endometriosis patients. Certification enhanced diagnostic precision, increased the use of ultrasound, improved surgical outcomes, and enabled more nuanced application of the #Enzian scoring system. Follow-up assessments became more consistent, reflecting stronger quality control. Despite remaining challenges, certification elevated the clinic's standard of care and emphasized patient-centered management.

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Outcome instruments

NRS-pain rASRM Enzian

Condition tags

endometriosisadenomyosis

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 (14)

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