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.