Prognostic Factors for Pain and Fertility Outcomes Following Laparoscopic Endometriosis Surgery: A Single-Center Experience

Mania  Kaveh; Fatemeh  Khodayari; Shahla  Chaichian; Abolfazl Mehdizadeh  Kashi; Mehdi  Afshari; Zahra  Shahraki; Kambiz  Sadegi

doi:10.18502/jri.v26i2.19434

Mania Kaveh Department of Obstetrics and Gynecology, School of Medicine, Amiralmomenin Hospital, Zabol University of Medical Sciences, Zabol, Iran
Fatemeh Khodayari Department of Obstetrics and Gynecology, School of Medicine, Amiralmomenin Hospital, Zabol University of Medical Sciences, Zabol, Iran
Shahla Chaichian Endometriosis Research Center, Iran University of Medical Sciences, Tehran, Iran
Abolfazl Mehdizadeh Kashi Department of Obstetrics and Gynecology, School of Medicine, Endometriosis Research Center, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
Mehdi Afshari Department of Community Medicine, School of Medicine, Pediatric Gastroenterology and Hepatology Research Center, Zabol University of Medical Sciences, Zabol, Iran
Zahra Shahraki Department of Obstetrics and Gynecology, School of Medicine, Amiralmomenin Hospital, Zabol University of Medical Sciences, Zabol, Iran
Kambiz Sadegi Department of Anesthesiology, School of Medicine, Amiralmomenin Hospital, Zabol University of Medical Sciences, Zabol, Iran

DOI: https://doi.org/10.18502/jri.v26i2.19434

Keywords: Endometriosis, Laparoscopic surgery, Postoperative pain, Surgical pain management.

Abstract

Background: Endometriosis is a prevalent condition among women, often leading to infertility. Laparoscopic surgery is widely employed as a therapeutic intervention for endometriosis. This study investigated the prognostic factors influencing the outcome of laparoscopic surgery for endometriosis.

Methods: This cross-sectional study included 60 women with endometriosis referred for laparoscopic surgery at Amiralmomenin Hospital, Zabol, Iran, between 2022 and 2024. Pain intensity was measured using a visual analog scale (VAS). Statistical analyses were performed using SPSS version 26. Descriptive statistics summarized the data, while univariate analyses (t-tests and chi-square tests) assessed relationships between variables. Multivariate logistic regression identified independent predictors of pain reduction and pregnancy outcomes.

Results: Patients with moderate endometriosis showed statistically significant pain reduction from 8.8 preoperatively to 1.8 at 9 months (p<0.001) and 2.2 at 12 months post-surgery (p=0.003). Those with severe endometriosis had non-significant pain reduction (8 to 6 at 12 months, p=0.12). Both intrauterine (9 to 1.1 at 12 months, p<0.001) and extrauterine involvement groups (8.6 to 3.3, p=0.004) demonstrated significant pain improvement, with no significant difference between the groups (p=0.779). Regarding fertility outcomes, treatment before the age of 30 significantly increased pregnancy likelihood (AOR=20.57, 95%CI 1.4-295.3), while other factors including BMI, CA125 levels, and parity showed no significant associations (all p>0.05).

Conclusion: These preliminary findings suggest that laparoscopic surgery may reduce pain in moderate endometriosis, while the age under 30 may be associated with improved pregnancy outcomes. However, given the study’s limited sample size and wide confidence intervals, these results require validation in larger, multicenter cohorts.