Surgical Management and Postoperative Quality of Life in Women with Endometriosis: A Cross-Sectional Study from Two Hospitals in Yaoundé, Cameroon

Background: Endometriosis is a chronic inflammatory disease with a substantial impact on quality of life (QoL) and reproductive health. In sub-Saharan Africa, delayed diagnosis and limited access to specialized care often result in advanced disease at the time of surgery. This study aimed to describe the surgical characteristics and assess postoperative quality-of-life outcomes among women operated for endometriosis in two referral hospitals in Yaoundé, Cameroon. Methods: We conducted a retrospective descriptive and analytical study involving women surgically treated for endometriosis between January 2018 and December 2023 at the Yaoundé Gyneco-Obstetric and Pediatric Hospital. Medical records of patients who underwent surgery for endometriosis were retrospectively reviewed. Sociodemographic, clinical, imaging, surgical, and postoperative data were extracted from 50 medical records. Pain intensity was assessed using the Visual Analog Scale (VAS), and quality of life was evaluated using the Endometriosis Health Profile-5 (EHP-5) questionnaire before and after surgery. Results: The mean age was 31.1 ± 5.5 years. The most common phenotypes were superficial endometriosis (68%). Advanced disease predominated, with a mean endometrioma diameter of 94.1 mm and a 36.4% prevalence of “kissing ovaries.” Deep infiltrating endometriosis (DIE) was identified in 38% of cases, including rare diaphragmatic and hepatic involvement. Moderate to severe disease (rASRM stages III-IV) was present in 70.3% of staged cases. Laparoscopy was the primary surgical approach (88%). A significant postoperative reduction in pain was observed, with the mean VAS score decreasing from 9.5 ± 1.1 to 3.7 ± 2.7 (p < 0.001). The EHP-5 score significantly improved from 698.8 ± 171.0 to 350.6 ± 219.5 (p < 0.001). Surgical complications were infrequent (6%). Postoperative conception occurred in 3 of 14 (21.4%) patients followed for infertility. Conclusion: In our Cameroonian cohort, endometriosis predominantly affects young, nulliparous women, often presenting with moderate-to-severe disease. Surgical management, predominantly laparoscopic, is associated with significant and meaningful improvements in pelvic pain and quality of life. These findings underscore the critical need for improved diagnostic capabilities and access to advanced laparoscopic surgery in our setting to mitigate the profound personal and societal burden of this disease.