Design: Retrospective cohort study of all patients who underwent endometriosis surgery between 2015 – 2020.

Setting: Two large academic teaching hospitals

Patients or Participants: All female patients, 18 years and older, who underwent surgical treatment for endometriosis via excision and/or ablation were identified using CPT code 58662. Patients were included if they had pathologic confirmation of endometriosis and excluded if they had a prior surgical diagnosis of endometriosis, concurrent malignancy, underwent surgery for infertility alone or if the finding was incidental on pathology.

Interventions: N/A

Measurements and Main Results: Our primary outcome was time to diagnosis of endometriosis, which was defined as date of onset of symptoms, as reported by patients through chart review, to date of surgery. A total of 410 patients were included (285 (69.5%) white, 38 (9.3%) black, 35 (8.5%) Asian, 48 (11.7%) Hispanic, 4 (0.9%) other). Age and parity were similar between groups. There was no significant difference in time to diagnosis of endometriosis between white and non-white patients, (mean 49 vs 48.8 months, p=0.97). There was no significant difference in presenting symptoms between groups, with dysmenorrhea and pelvic pain the two most common (37.9 and 51.2% amongst all patients, respectively). Non-white patients were more likely to have pain symptoms with associated infertility (22.3% vs 13%, p=0.02) and a prior diagnosis of fibroids (34.7% vs 25.3%, p=0.05), whereas white patients were more likely to have a prior diagnosis of pelvic floor dysfunction (5.6% vs 0.8%, p = 0.03).

Conclusion: There was no significant difference in time to diagnosis of endometriosis between white and non-whites in our study population. Additional research is warranted to characterize specific differences in endometriosis diagnosis and management amongst patients of different racial backgrounds.