Design: A prospective cohort study

Setting: A tertiary hospital in Brazil.

Patients or Participants: 124 women, over 18 years of age, who underwent endometriosis surgery by the same surgical team at a referral center between 2022 and 2023.

Interventions: Clinical data, pain symptoms assessed on a scale from 0 to 10, and type of surgery (simple and complex endometriosis) were collected. The Short Form 36 questionnaire was administered to assess QoL preoperatively, at 3, and at 6 months postoperatively. Statistical analysis used Chi-square test or Mann-Whitney test. Longitudinal analysis of QoL was performed using linear regression models with mixed effects.

Measurements and Main Results: 64.2% (n=80) of women were from the public sector and 25.8% (n=44) from the private sector. There was no significant difference in BMI values, age at menarche, comorbidities, previous endometriosis surgeries, hormonal treatment, or type of surgery between the groups (p>0.050). Patients from the private sector reported more intense dyschezia compared to the public sector (6.0 [SD=2.8] versus 1.0 [SD=2.5]; p =0.003). There was an increase in mean QoL scores between pre- and post-surgical periods in both groups (p<0.001) for all evaluated domains, with mean increments ranging from β = 6.4 (SE=1.2) for mental health to β = 14.6 (SE=2.2) for Physical Functioning. However, when analyzing the interaction between types of surgeries, group, and QoL over time, no statistically significant differences were observed (p>0.050).

Conclusion: There was a significant and similar improvement in QoL in both evaluated groups. Patients from the private sector presented more dyschezia preoperatively compared to the public sector.