Surgery for Endometriosis Improves Major Domains of Quality of Life: A Systematic Review and Meta-Analysis

Because surgery for endometriosis can involve severe complications, it is important to determine if the patient's quality of life (QOL) is indeed improved after surgery. A systematic review and meta-analysis, when appropriate, was conducted and included 38 studies that assessed the QOL using validated questionnaires administered before and after surgery. Results were grouped according to the type of endometriosis reported: all types endometriosis, deep infiltrative endometriosis (DIE), and bowel endometriosis. Quantitative analysis was performed on 17 homogeneous studies. Pooled response mean differences between the 36-Item and 12-Item Short Form Survey (SF-36 and SF-12) showed significant improvement in Mental Component Score (MCS) after surgery for all types of endometriosis (.21; 95% confidence interval [CI], .04–.38); significant improvement after surgical treatment for DIE in Vitality (.67; 95% CI, .41–.94), Social Functioning (.59; 95% CI, .18–.99), Role Emotional .49; 95% CI, .02–.97), Mental Health (.39; 95% CI, .03–.74), Physical Functioning (.93; 95% CI, .49–1.38), Bodily Pain (1.23; 95% CI, .47–1.99), General Health (.57; 95% CI, .02–1.12), MCS (.55; 95% CI, .10–1.00), and Physical Component Score (PCS; .73; 95% CI, .27–1.18); and significant improvement after surgery for bowel endometriosis for all 8 domains (Vitality [1.00; 95% CI, .56–1.43], Social Functioning [.97; 95% CI, .57–1.37], Role Emotional [1.17; 95% CI, .7–1.63], Mental Health [.94; 95% CI, .5–1.38], Physical Functioning [.74; 95% CI, .3–1.18], Role Physical [1.25; 95% CI, .75–1.76], Bodily Pain [1.39; 95% CI, .79–1.98], General Health [.84; 95% CI, 1.46–1.22]), MCS (.93; 95% CI, .47–1.40), PCS (.82; 95% CI, .40–1.23), and total score (1.15; 95% CI, .48–1.83). Only 1 study assessed patients with minimal disease and showed significant improvement in PCS (p?=?.002) and MCS (p <.001). This systematic review reveals that surgery for endometriosis resulted in overall improvement in most health domains of health-related QOL, with the greatest improvement found in the Bodily Pain domain.