AB204. SOH25_AB_328. A 10-year retrospective review of peritonectomies performed for endometriosis

Background: Endometriosis gives rise to significant challenges in surgical management. We aimed to review all surgeries performed for presumed endometriosis in two Cork gynaecology units and correlate subjective pain improvement correlated with cyclical pelvic pain pre-operatively, and histological confirmation of endometriosis.

Methods: A retrospective review was performed of all patients undergoing surgery for presumed endometriosis from 2014 to 2023. Subjective symptomatic relief was assessed four months post-surgery.

Results: Over the 10-year period, 138 patients underwent laparoscopic excisional surgery for presumed endometriosis [mean age 34 years (range, 17–52 years)]. Of these, 63% (80/138) of patients had previous surgery for endometriosis. A proportion of 52.2% (72/138) were on hormonal treatment pre-operatively, and of those that did not have a history of bilateral salpingo-oophorectomy, 59% (73/124) commenced hormonal suppression post-operatively, and 18.5% (23/124) subsequently became pregnant. Histology reports were available in 100 patients—78% with confirmed/probable endometriosis and 22% with no endometriosis diagnosed. Post-operative symptom improvement was assessed in 97 patients. Symptomatic improvement was reported in 82% (49/60) of patients who had histologically-confirmed endometriosis, compared to 62% (10/16) of those without a confirmed diagnosis. Cyclical pelvic pain was reported in 66% (91/138) of patients pre-operatively and of these, 65 patients underwent symptom assessment post-operatively—86% (56/65) reported symptomatic improvement. A further 5% of patients (5/91) were pregnant at their post-op appointment. Endometriosis was histologically confirmed in 61% (22/36) of those with continuous pelvic pain.

Conclusions: There is a higher rate of histologically-confirmed endometriosis in patients with cyclical pelvic pain, and these patients have greater symptomatic relief post-operatively. This information will allow us to counsel these patients better before surgery.

Keywords: Chronic pelvic pain; endometriosis; laparoscopic excision of endometriosis; laparoscopy; peritonectomy