Tertiary Center Experience with the Treatment and Follow-Up of Endometriosis

Özet

Objective: Endometriosis is a chronic disease that affects 10% of women of reproductive age. No curative treatment is currently available due to the as yet unclear pathophysiology. Therefore, clinical experience and additional knowledge of the disease has great value. This study was an investigation of the demographic characteristics, symptoms, medication use, analgesic need, and treatment methods of endometriosis patients at a tertiary gynecological clinic in order to evaluate long-term clinical strategies. Methods: This retrospective, descriptive case study was conducted at a tertiary gynecological clinic. A database search of records from November 2012 to July 2020 yielded a total of 1098 patients for initial inclusion in the study. Age, gravidity, parity, surgical history, and demographic characteristics were recorded, as well as the diagnostic methods, medical and surgical treatment strategies, hospitalization duration, and need for analgesic medication. Results: In all, 873 patients had stage 3 disease and 6 patients were diagnosed with stage 4 disease. Of the study group, 47% of the patients were diagnosed using ultrasound and 53% were diagnosed surgically. An assessment of the surgical techniques used revealed that 144 patients underwent laparoscopic surgery while 235 underwent a laparotomy. The mean duration of hospitalization following a laparoscopy was 2.68±1.02 days, whereas the mean length of stay following a laparotomy was 3.45±1.69 days. Analysis of the medical treatment strategies applied indicated that 110 patients were given a combined oral contraceptive (COC), 36 received progesterone, and 525 were treated with dienogest. Conclusion: Although there has been an ongoing search for a curative treatment for endometriosis for some time, the treatment options have not changed dramatically over the years. Laparoscopic surgery has largely taken the place of a laparotomy as surgeons became more experienced and progestins have gained more importance as a medical treatment option. However, at present, regardless of treatment strategy, endometriosis still requires a long period of treatment and follow-up.