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Wednesday, 15 April 2009

The Success of Surgery

A surgical procedure is often required for women with endometriosis if drug treatments fail to control the symptoms, but how successful are the different types of surgery? An American study published last year in the Journal Obstetrics and Gynaecology reported the success rates of three different types of surgery:
- Excision of endometriosis alone
- Hysterectomy without removing ovaries
- Hysterectomy with removing ovaries
The study followed patients undergoing these procedures and noted whether they required further surgery after 2, 5 and 7 years. The results were as follows:

Of the women who underwent excision of endometriosis only:
After 2 years 30.6% of women needed further surgery
After 5 years 46.7% needed more surgery
After 7 years 65.4% needed more surgery

Of the women who underwent hysterectomy, but kept their ovaries:
After 2 years 4.3% of women needed further surgery
After 5 years 13.4% needed further surgery
After 7 years 23% needed further surgery

Of the women who underwent hysterectomy and ovary removal:
After 2 years 4% of women needed further surgery
After 5 years 8.3% needed further surgery
After 7 years 8.3% needed further surgery

So it would appear that surgical excision of endometriosis alone is associated with a high rate of recurrent surgical procedures. Hysterectomy with ovary removal was the most successful (but least appealing) procedure. One thing to consider though, is that the abstract for this paper did not state whether the patients participating in this study were taking any medical therapy and whether this affected their recovery rates.

A link to the article can be found here

1 comment:

  1. Dear Matt,

    Thanks for this article on the effectiveness of surgery. What's interesting is that the majority of women who had a lap alone, one of the most common surgical procedures for women with endo, had to have another one, even though it was an excision surgery. There have been many rumors as of late that have suggested that excision surgery is the "cure" for endo.

    What I would be interested in knowing, having read the study, is how many of these hysterectomy patients still complained of symptoms but were referred to other specialties. Perhaps their doctor felt that since they had everything removed endo couldn't possible be their problem still.

    As well, the report only states the percentage of women who required further surgeries. Were some women who complained of returning symptoms treated with other methods of controlling their symptoms? It's an interesting question to ask.

    Take care,
    Melissa

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