Appendectomy in the surgical management of women with endometriosis and pelvic pain

Whitney Trotter Ross, Amanda Chu, Linda Li, Allen R Kunselman, Gerald Harkins, Gerald J Harkins, Timothy A Deimling, Timothy Deimling, Andrea S Benton, Andrea Benton
International Journal of Gynecology & Obstetrics · 2021 · vol. 154(3) , pp. 526–531 · doi:10.1002/ijgo.13614 · W3123462835
article OA: closed CC0 ⤵ 9 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

Appendectomy during gynecologic surgery for pelvic pain and/or endometriosis is safe and identifies appendiceal endometriosis in 14.9% of cases, supporting its consideration in endometriosis management.

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Abstract

Abstract Objective To evaluate the role of appendectomy in surgical excision of endometriosis and to assess complications associated with appendectomy. Methods Retrospective study of women undergoing appendectomy for pelvic pain and/or endometriosis during a primary gynecologic procedure. Results Record review was performed for 609 women who underwent appendectomy between 2013 and 2019 for pelvic pain (6.9%, 42/609), stage I–II endometriosis (63.7%, 388/609), or stage III–IV endometriosis (29.4%, 179/609). Appendiceal endometriosis (AppE) was present in 14.9% (91/609); 2.4% without endometriosis (1/42, reference group), 7.0% with stage I–II endometriosis (27/388, odds ratio [OR] 3.06, 95% confidence interval [CI] 0.41–23.11, P = 0.278), and 35.2% with stage III–IV endometriosis (63/179, OR 22.24, 95% CI 2.99–165.40, P = 0.002). AppE was significantly associated with endometriosis present in other locations (OR 5.27, 95% CI 2.66–10.43, P < 0.001). The predicted probability of identifying AppE ranged from 6% with 0 positive endometriosis sites to 56% when 4 or more sites were identified. There were no complications related to the performance of an appendectomy. Conclusion Women with chronic pelvic pain and/or endometriosis have an increased risk of AppE. Modern appendectomy at the time of gynecologic surgery is safe, with no associated complications in this study. Our findings support the consideration of appendectomy as part of the comprehensive surgical management of endometriosis.

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Condition tags

mesh:D004715mesh:D017699endometriosischronic_pelvic_pain

MeSH descriptors

Appendix Endometriosis Endometriosis Endometriosis Endometriosis Laparoscopy Appendectomy Appendectomy Female Humans Pelvic Pain Pelvic Pain Pelvic Pain Retrospective Studies

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