Long-Term Follow-Up of the Quality of Life of Endometriosis Patients after Surgery: A Comparative Study

<b>Background/Objectives:</b> This study investigated the long-term effects of the surgical removal of endometriotic lesions on quality of life in endometriosis patients. A sub-analysis explored different subtypes of endometriosis, hormonal influence, and the need for reoperation. <b>Methods:</b> The study was conducted at the Certified Endometriosis Center of the Medical University of Vienna. Included in the study were patients who had undergone the complete surgical removal of endometriotic lesions between 2014 and 2018. Patients were asked to complete the Endometriosis Health Profile-30 preoperatively, at the short-term follow-up (six to ten weeks postoperatively), and at the long-term follow-up (median of 48 months postoperatively). <b>Results:</b> A total of 87 patients completed the Endometriosis Health Profile-30 at the three time points. At the long-term follow-up, the reoperation rate was 8.0%. Significant improvements in the overall quality of life (<i>p</i> < 0.001; median decrease from 45.0 to 11.7) and in the categories of "pain", "control and powerlessness", "social support", "emotional well-being", and "self-image" at the long-term follow-up compared to preoperative values were observed (<i>p</i>-values < 0.01). The sub-analysis showed that patients with deep-infiltrating endometriosis (<i>p</i> < 0.001; median decrease from 49.2 to 10.0) and adenomyosis (<i>p</i> < 0.02; median decrease from 37.5 to 0.0) had the most pronounced long-term postsurgical benefits in terms of quality of life. Patients with (<i>p</i> < 0.001; median decrease from 45.0 to 1.7) and without (<i>p</i> < 0.001; median decrease from 45.42 to 12.5) hormonal influence showed significant improvements in overall quality of life compared to preoperative values. Patients without reoperation demonstrated improved long-term quality of life compared to the preoperative (<i>p</i> < 0.001; median decrease from 45.8 to 9.6) and short-term follow-up results (<i>p</i> < 0.005; median decrease from 19.2 to 9.6). Participants who underwent reoperation showed no improvement in quality of life at the long-term follow-up. <b>Conclusions</b>: The surgical removal of endometriotic lesions has a positive long-term impact on the quality of life, as measured by Endometriosis Health Profile-30.