Does "Aggressivity" of Endometriosis Correlate to Clinical History or Outcomes?

The study design is an investigator-initiated pilot, prospective cohort study (Canadian Task Force, II-3). Patients will not be randomized.

Consecutive subjects from age 14-55 will be recruited and included in the study if they are seeking treatment of pain and with suspected or known endometriosis. Patients who are menopausal (either chemically-induced, natural or surgical) will not be included in the study. Patients who are pregnant are not eligible for surgery, and not eligible to be in the study. Subjects will be excluded if they are found not to have endometriosis confirmed by histology. All surgeries are performed at a single institution, St. Mary's Hospital.

An ad hoc sample size calculation is not possible for this pilot study, since we have no historic data on which to base such a calculation. The goal is to acquire 45 panel results, as a reasonable amount of data for a pilot study, and given the funding available.

Quality of life (measured by the 100-point scale and by the EHP-5) and pain indices (measured by the VAS scale) will be measured at up to six different time points: before surgery, six months after surgery, and one year after each surgery. At each time point you will compare quality of life and each pain index across the four aggressivity groups of low, moderate, medium, and high using analysis of variance (ANOVA) or the non-parametric Kruskal-Wallis test depending on the normality of the distributions. Pairwise comparisons will also be made using independent students t test or the non-parametric Kolmogorov-Smirnov test depending on the normality of the distributions.

The follow-up time frame for each surgery will be 1 year. Patients will receive questionnaires pre op and at 6-months and 1 year for both the first surgery and the second surgery( if needed). The entire study will take about 4 years, including data analysis and publication. .