Evaluation of long-term symptoms and recurrence of bowel nodules after resection of deep bowel endometriosis: A retrospective cohort study

Background — Bowel endometriosis nodules (BEN) result from an abnormal growth of endometrial fragments located on intestine causing visceral pain, scars, and organ adhesions. Deep endometriosis operation (DEO) is performed in case of deep infiltrating endometriosis (DIE) as a routine procedure for BEN excision. In this retrospective cohort study, the authors aimed to investigate the long-term symptoms and the recurrence rate of BEN in DIE women. Methods — The cases were pooled into two groups based on presence of surgery of bowel endometriosis (SBE, n=32) and absence of surgery of bowel endometriosis (no-SBE, n=44). Using inclusion and exclusion criteria, we selected 76 DIE women from Arash Women’s Hospital (Tehran, Iran). General patient information and surgery-related data were extracted from medical histories of DIE patients (2018-2021). Two years of postoperative follow-up were part of our study, and endometriosis symptoms, pelvic pain, and BEN recurrence rate were assessed. Data were analyzed using SPSS (v.19), and statistical significance was assumed at p<0.05. Results — No statistically significant (p=0.54) differences were detected between two groups (SBE and no-SBE) regarding pain recurrence. In SBE group, 28.1% of DIE women exhibited BEN recurrence, while this proportion was 9.4% in no-SBE women that had larger size of BEN. Changes in BEN sizes were not significant (p=0.6) as compared with pelvic pain. Conclusion — No significant differences were found between long-term symptoms and recurrence of BEN in women with DIE after SBE and without SBE. Excision of BEN during surgical procedures is not recommended clinically.