Defining Surgical Success in Endometriosis: A Patient-Centered Pilot Study

Area of Science:

• Gynecology and Surgical Research
• Patient-Reported Outcomes
• Endometriosis Management

Background:

• Endometriosis significantly impacts quality of life and pain.
• Defining surgical success from a patient's perspective is crucial for effective treatment.
• Current definitions of surgical success may not fully align with patient expectations.

Purpose of the Study:

• To define surgical success in endometriosis based on patient-centered outcomes.
• To determine patient-defined improvements in pain and quality of life indicative of surgical success.
• To establish a patient-reported threshold for successful endometriosis surgery.

Main Methods:

• Pilot study involving 36 patients with symptomatic endometriosis scheduled for surgery.
• Online survey assessing patient definitions of surgical success/failure and expected symptom improvement.
• Mixed-methods approach combining qualitative and quantitative data analysis.

Main Results:

• 97% of patients identified improved quality of life as the primary determinant of surgical success.
• A consensus on surgical failure was not reached.
• Patients expected a mean minimal reduction of 34 points in the Endometriosis Health Profile (EHP-30) score.
• Most patients (91.7%) aimed for a postoperative EHP-30 score below 40.
• Patients anticipated a 52%-69% reduction in pain symptom scores.

Conclusions:

• Improvement in quality of life is the most significant patient-reported outcome for surgical success in endometriosis.
• A target EHP-30 score below 40 represents a successful surgical outcome for the majority of patients.
• Establishing a standardized, patient-defined threshold for surgical success can enhance clinical practice and research in endometriosis.