Incidence of symptom recurrence after hysterectomy for endometriosis

A. B. Namnoum, T. N. Hickman, S. B. Goodman, D. L. Gehlbach, J. A. Rock

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203 Scopus citations


Objectives: To determine the relative risk of symptom recurrence and/or reoperation after hysterectomy with ovarian preservation for the treatment of endometriosis. Design: Historical prospective study of patients with endometriosis who underwent hysterectomy with or without ovarian preservation. Patients: One hundred thirty-eight women who underwent hysterectomy with the diagnosis of endometriosis. Methods: A computer search identified 138 women who underwent hysterectomy with the diagnosis of endometriosis at Johns Hopkins Hospital from 1979 to 1991. Follow-up information was obtained from medical records, outpatient charts, and telephone surveys. Results: Twenty-nine women had hysterectomy with some ovarian tissue preserved; 109 had all ovarian tissue removed. Of those with ovarian preservation, 18 of 29 (62%) had recurrent pain and 9 of 29 (31%) required reoperation. Of those who had no ovarian preservation, 11 of 109 (10%) had recurrent symptoms and 4 of 109 (3.7%) required reoperation. Ovarian conservation was associated with a relative risk for pain recurrence of 6.1 (95% confidence interval [CI] 2.5 to 14.6) compared with patients with oophorectomy in a Cox proportional hazards model. The relative risk for reoperation in patients with ovarian conservation was 8.1 (95% CI 2.1 to 31.3). Conclusion: Compared with women who had oophorectomy for endometriosis, patients who underwent hysterectomy with ovarian conservation had 6.1 times greater risk of developing recurrent pain and 8.1 times greater risk of reoperation.

Original languageBritish English
Pages (from-to)898-902
Number of pages5
JournalFertility and Sterility
Issue number5
StatePublished - 1995


  • Cox hazard model
  • Endometriosis
  • estrogen replacement
  • hysterectomy
  • multivariate analysis
  • ovarian conservation
  • reoperation
  • symptom recurrence


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