Does laparoscopic management of deep infiltrating endometriosis improve quality of life? A prospective study

Abstract

BackgroundDeep infiltrating endometriosis (DIE) can affect importantly patients' quality of life (QOL). The aim of this study is to evaluate the impact of the laparoscopic management of DIE on QOL after six months from treatment.MethodsIt is a prospective cohort study. In a tertiary care university hospital, between April 2008 and December 2009, 100 patients underwent laparoscopic management of DIE and completed preoperatively and 6-months postoperatively a QOL questionnaire, the short form 36 (SF-36).Quality of life was measured through the SF-36 scores. Intra-operative details of disease site, number of lesions, type of intervention, period of hospital stay and peri-operative complications were noted.ResultsSix months postoperatively all the women had a significant improvement in every scale of the SF-36 (p < 0,0005). Among patients with intestinal DIE, significant differences in postoperative scores of SF-36 were not detected between patients submitted to nodule shaving and segmental resection (p > 0.05). There was no significant difference in the SF-36 scores at 6 months from surgery between patients who received postoperative medical treatment and patients who did not (p > 0.05).ConclusionsLaparoscopic excision of DIE lesions significantly improves general health and psycho-emotional status at six months from surgery without differences between patients submitted to intestinal segmental resection or intestinal nodule shaving.

Quality of Life Improvement after Surgery for Deep Infiltrating Endometriosis (DIE)

“…On the same note, Abbott et al (2004) have demonstrated a placebo effect of surgery on quality of life in 30% of patients with DIE [58]. Using qualitative and semiquantitative evaluations of symptoms, Redwine and Wright (2001) has convincingly demonstrated that women with predominant low back pain or asthenias are less likely candidates for extensive surgery [59]. However, we observed these data are partly in contrast with a previous report [60] with no reduction in medium-or long-term frequency and severity of recurrent dysmenorrhea after laparoscopic uterosacral ligament resection.…”

Life quality of patients with endometriosis

“…Препаратом первой линии для долговремен-ного лечения болевого синдрома при эндометриозе можно считать диеногест 2 мг. Согласно рекоменда-циям SOGC Clinical Practice Guideline [1,7,8,10,27,28,30,31], монотерапия прогестинами внутрь отно-сится к первой линии терапии, а терапия а-ГнРГ в комбинации с заместительной гормональной тера-пией в качестве возвратной терапии является тера-пией второй линии.…”

“…Принципиально значимыми социальными аспектами при эндоме-триозе являются: влияние заболевания на трудовую e-mail: sonova@rambler.ru деятельность и образование, работоспособность, от-ношения с окружающими, отношения с детьми, ко-торые складываются в составляющие качества жиз-ни [5,6,17,22,23,29,35,38]. Показано, что степень социальной дисфункции выше у больных с болевым синдромом в разных его проявлениях в сравнении с больными, не имеющими болевого синдрома [2,4,7,9]. Социальное функционирование является одной из главных составляющих качества жизни.…”

“…психического и социального благополучия [3,7,9,11]. Наиболее известными из применяемых в насто-ящее время специальных опросников для больных эндометриозом являются Endometriosis Health Profile-30 (EHP-30) и его модификация Endometriosis Health Profile-5 (EHP-5) [11].…”

Is there a role for ultrasound surveillance for asymptomatic women with advanced endometriotic disease?

“…Posterior pelvic compartment deep infiltrating endometriosis (DIE) is known to be significantly associated with specific pelvic pain symptoms, and the excision of DIE has been shown to improve quality of life for these women 1 . However, the enigma of DIE and stage IV endometriosis is that not all of these women present with pain.…”