Kohl Cynthia, Kager Jana, Donutiu Raul, Gerken Michael, Papathemelis Thomas
Klinik für Frauenheilkunde und Geburtshilfe, Klinikum St. Marien Amberg, Amberg, Germany.
University of Regensburg, Regensburg, Germany.
Geburtshilfe Frauenheilkd. 2025 May 19;85(9):941-950. doi: 10.1055/a-2593-0666. eCollection 2025 Sep.
Endometriosis is a very common benign condition in women. In recent years certification of health care institutions has led to a more standardized care for endometriosis patients, aiming at improving the quality of diagnosis and treatment. The introduction of a common classification system facilitates quantification of disease extent. This study investigated whether certification of a rural endometriosis clinic ameliorated care in endometriosis patients.
A single-center retrospective data analysis was performed of all endometriosis patients that underwent surgery at the investigated institution, certified in 2019, for the years 2018-2022.
Between 2018 and 2022, a total of 812 surgeries were performed, with certification significantly improving diagnostic and surgical outcomes. Post-certification, there was an increase in ultrasound utilization (47.7% vs. 35.6%, p = 0.007), greater recognition of adenomyosis (65.8% vs. 57.0%, p = 0.035), and higher rates of complete lesion removal (92.5% vs. 87.8%, p = 0.011). Pain outcomes also improved, with more patients achieving pain relief 12 months postoperatively (40.5% vs. 34.5%, p = 0.196 vs. < 0.001). Additionally, certification enhanced follow-up assessments (64.1% vs. 40.7%, p < 0.001) and documentation of rectal lesions in patients with dyschezia (p < 0.001), indicating a positive impact on overall care quality.
This study shows that certification significantly improved care for endometriosis patients. Certification enhanced diagnostic precision, increased the use of ultrasound, improved surgical outcomes, and enabled more nuanced application of the #Enzian scoring system. Follow-up assessments became more consistent, reflecting stronger quality control. Despite remaining challenges, certification elevated the clinic's standard of care and emphasized patient-centered management.
子宫内膜异位症是女性中非常常见的良性疾病。近年来，医疗机构认证促使子宫内膜异位症患者的护理更加标准化，旨在提高诊断和治疗质量。引入通用分类系统有助于量化疾病范围。本研究调查了农村子宫内膜异位症诊所的认证是否改善了子宫内膜异位症患者的护理。
对2018 - 2022年在2019年获得认证的被调查机构接受手术的所有子宫内膜异位症患者进行单中心回顾性数据分析。
2018年至2022年期间共进行了812例手术，认证显著改善了诊断和手术结果。认证后，超声使用率增加（47.7%对35.6%，p = 0.007），子宫腺肌病的识别率更高（65.8%对57.0%，p = 0.035），完全切除病灶的比例更高（92.5%对87.8%，p = 0.011）。疼痛结果也有所改善，更多患者在术后12个月实现疼痛缓解（40.5%对34.5%，p = 0.196对<0.001）。此外，认证加强了随访评估（64.1%对40.7%，p < 0.001）以及对排便困难患者直肠病变的记录（p < 0.001），表明对整体护理质量有积极影响。
本研究表明，认证显著改善了子宫内膜异位症患者的护理。认证提高了诊断精度，增加了超声的使用，改善了手术结果，并使#恩济安评分系统得到更细致的应用。随访评估变得更加一致，反映出更强的质量控制。尽管仍存在挑战，但认证提高了诊所的护理标准，并强调了以患者为中心的管理。
