Is Endometriosis Associated With Post-Operative Complication Rates After Hysterectomy?
In a retrospective cohort study,1 researchers found that patients with endometriosis had higher postoperative complication rates after hysterectomy compared with those without endometriosis.
Hysterectomy is the second-most common surgery for women in the United States, behind only cesarean sections. Endometriosis affects about 15% of women, and its symptoms may lead to hysterectomy.2
Using data collected in the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database, researchers assessed how endometriosis affects outcomes in patients undergoing hysterectomy for benign disease. After adjusting for group differences, differences in the primary outcomes were compared between patients with and without endometriosis.
The researchers identified more than 125,000 hysterectomies for reasons other than cancer between January 1, 2014, and December 31, 2019. Of those, 19,618 (15.4%) had a diagnosis of endometriosis. Although patients with endometriosis were younger and had a lower prevalence of chronic comorbidities, according to the database, they also had higher rates of concurrent pelvic inflammatory disease and previous abdominal operations.
The incidence of postoperative complications was higher in patients with endometriosis (9.9%) compared with those without endometriosis (8.1%; odds ratio [OR], 1.25; 95% CI, 1.17–1.34). Researchers found no differences between the two groups for incidence of 30-day mortality (0.1% vs 0.03%; OR = 1.98; 95% CI, 0.69–5.65) or reoperations (1.50% vs 1.36%; OR = 1.18; 95% CI, 0.98–1.42).
“Postoperative complications are more likely in hysterectomies involving endometriosis than those without endometriosis, likely owing to anatomic distortion incurring increased surgical complexity,” the authors concluded. “Patients and surgeons should be aware of the increased risk of complications and plan for mitigating these increased risks before and during surgery for suspected endometriosis.”
References:
- Wang EB, Chang S, Bossa D, Rosero EB, Kho KA. Association between endometriosis and surgical complications among benign hysterectomies. J Minim Invasive Gynecol. 2023;30(12):990-998. doi:10.1016/j.jmig.2023.09.003
- Endometriosis can complicate hysterectomies, UTSW study shows. UT Southwestern Medical Center. Press release. October 23, 2023. https://www.newswise.com/articles/endometriosis-can-complicate-hysterectomies-utsw-study-shows?sc=dwhr&xy=10026517.