Abstract
Objective: There are no studies directly comparing medical vs surgical treatments in improving endometriosis-related pain despite the condition’s widespread prevalence. The COVID-19 pandemic restrictions resulted in many endometriosis patients unable to receive surgical treatment, providing an opportunity to compare non-surgical management directly against the conventional practice of surgery. We also explored the impact of the pandemic on the quality of care and quality of life for endometriosis patients. Methods: An online questionnaire was conducted between June and August 2023. Patients from a single centre were asked to participate if they had received surgery in 2018−2019 or received non-surgical management in 2020−2022. The questionnaire measured impacted endometriosis care, quality of life over the pre-, during, and post-pandemic periods with the endometriosis impact questionnaire (EIQ), and treatment effectiveness with the numerical rating scale (NRS). Results: Of the 60 total respondents, 56.7% had a cancelled, postponed, or rescheduled clinic appointment, while 33.3% were impacted for endometriosis surgery and 8.3% for fertility treatment. There were no statistically significant differences in EIQ scores during or after the pandemic as compared to before and during for all domains. Both surgery and non-surgical treatment decreased NRS scores significantly by 3, p < 0.001. There was no significant difference between the two treatments, p = 0.901. Conclusion: The quality of life of endometriosis patients remained stable despite disruptions to care during the COVID-19 pandemic. Both surgical and non-surgical treatments are effective for endometriosis-related pain, although how one compares to the other is still unclear due to systematic differences between study cohorts.