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Abstract

BACKGROUND: More research is needed comparing post-surgical outcomes between patients who undergo hysterectomy for endometriosis with or without ovarian conservation. OBJECTIVE: To compare the rate of reoperation and use of other pain-related health services after hysterectomy for endometriosis, with or without ovarian conservation METHODS: A population-based retrospective cohort study of 4489 patients aged 19-50 in British Columbia, Canada, undergoing hysterectomy for endometriosis between 2001 and 2016. Index surgeries were classified as: hysterectomy alone (conservation of both ovaries), hysterectomy with unilateral salpingoophorectomy (USO), or hysterectomy with bilateral salpingoophorectomy (BSO). Reoperation rate was the primary outcome. Secondary outcomes (measured at 3-12 months and 1-5 years after hysterectomy) included: physician visits for endometriosis and pelvic pain, prescriptions filled for opioids and hormonal suppression medications and hormone replacement therapy (HRT). RESULTS: 89.5% of patients remained reoperation free by the end of follow-up (median of 10 years, IQR = 6.1 to 14.3 years). Patients undergoing hysterectomy alone were more likely to undergo at least one reoperation compared to those having hysterectomy with BSO (13% vs 5%, p