Medical and surgical interventions to improve the quality of life for endometriosis patients: a systematic review

D’Alterio, Maurizio Nicola; Saponara, Stefania; Agus, Mirian; Laganà, Antonio Simone; Noventa, Marco; Loi, Emanuela Stochino; Féki, Anis; Angioni, Stefano

doi:10.1186/s10397-021-01096-5

Cited by 29 publications

(30 citation statements)

References 91 publications

(164 reference statements)

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“…All these results indicated that DIE surgery could effectively improve pain symptoms. D’Alterio et al [ 37 ] demonstrated that many medical and surgical treatments could demonstrate benefits in pain control and quality-of-life improvement. Overall, the surgical approach for severe DIE may be more effective and decisive.…”

Section: Discussionmentioning

confidence: 99%

Reproductive and postsurgical outcomes of infertile women with deep infiltrating endometriosis

et al. 2022

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Background This study aimed to summarize and analyze clinical characteristics and reproductive outcomes in postoperative deep infiltrating endometriosis (DIE). Methods This retrospective cohort study included 55 reproductive-aged patients who were diagnosed with DIE, wished to conceive and underwent resection surgery at the Obstetrics and Gynecology Hospital, Fudan University, from January 2009–June 2017. Those with any plausible infertility factor or abnormalities in the partner’s semen analysis were excluded. Patient characteristics, preoperative symptoms, infertility history, intraoperative findings and reproductive outcomes were followed up and recorded. Risk factors for reproductive outcomes were identified for women who became pregnant versus those who did not by univariate logistic regression. Additionally, pre- and postoperative endometriosis health profile questionnaire-30 (EHP-30), Knowles–Eccersley–Scott Symptom questionnaire (KESS), Cox Menstrual Symptom Scale (CMSS) and Female Sexual Function Index (FSFI) scores were used to evaluate the effect of DIE surgery on quality of life. Results The average age was 30.22 ± 3.62 years, with no difference between the pregnancy and nonpregnancy groups. The average follow-up time was 26.57 ± 14.51 months. There were 34 pregnancies (61.82%): 24 (70.59%) conceived spontaneously and 10 (29.41%) by in vitro fertilization (IVF). Twenty-eight patients (82.35%) had term deliveries. The interval between operation and pregnancy was 10.33 ± 5.6 (1–26) months. Univariate analysis showed that a lower endometriosis fertility index (EFI) score (EFI < 8) was a risk factor for infertility (OR: 3.17 (1.15–10.14), p = .044). For patients with incomplete surgery, postoperative gonadotropin-releasing hormone agonist (GnRHa) administration improved the pregnancy rate (p < 0.05). Regarding quality of life, there was significant improvement (p < 0.05) in the postoperative EHP-30, KESS and CMSS scores compared with preoperative scores in both groups. Although there was no obvious difference in FSFI scores, significant improvement in dyspareunia was observed (p < 0.05). Conclusions Overall, the postoperative pregnancy rate of DIE patients was 61.82%. Surgical management of DIE for patients with complaints of pain and with pregnancy intentions was feasible and effective. Long-term expectant treatment should not be advised for patients with lower EFI scores (EFI < 8), and postoperative IVF–ET may be a good choice. More cases should be enrolled for further study, and randomized studies are required.

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Section: Discussionmentioning

confidence: 99%

Reproductive and postsurgical outcomes of infertile women with deep infiltrating endometriosis

et al. 2022

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“…This study found an improvement in all physical and mental aspects of the QoL. The Endometriosis Health Profile-30 (EHP-30) questionnaire is more specific and should be adopted in cases where the diagnosis of endometriosis is ultrasound or surgically confirmed [ 16 ]. The SF-36 questionnaire was chosen to use in the current investigation because the study was based on the pain symptoms suggestive of endometriosis diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Randomized study on the effectiveness of nomegestrol acetate plus 17β-estradiol oral contraceptive versus dienogest oral pill in women with suspected endometriosis‑associated chronic pelvic pain

et al. 2022

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Background To evaluate the effects of a combined oral contraceptive containing 1.5 mg 17b-estradiol (E2) and 2.5 mg nomegestrol acetate (NOMAC) or 2 mg/daily dienogest (DNG) oral progestin on endometriosis-associated chronic pelvic pain (CPP) and on the quality of life (QoL) and sexual function, by a randomized study design. Methods The E2/NOMAC group and DNG group included 99 and 98 women, respectively. The levels of CPP were measured by the visual analogic scale (VAS). The QoL scores were investigated by the Short Form-36 questionnaire (SF-36). Finally, sexual function was studied using the Female Sexual Function Index (FSFI), while sexual distress was studied by the Female Sexual Distress Scale (FSDS). The study had 3, 6 and 12-month follow-ups. Results The intra-group analysis showed an improvement of the VAS score from baseline to the 12-month follow-up in the women of both groups (p < 0.001). The inter-group comparison showed a similar improvement of CPP (p = 0.06). Women on DNG had better SF-36 somatic (p < 0.01) and FSFI scores (p < 0.006) than women on E2/NOMAC at the 6- and 12-month follow-ups. Conclusions The results support the efficacy of both hormonal treatments, even if DNG was more effective than E2/NOMAC in a limited intergroup comparison.

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“…Those with endometriosis report a significant economic burden [ 8 ], issues at work [ 9 ] and in education [ 7 ], poor mental health [ 10 , 11 ] and the breakdown of sexual relationships [ 7 ]. All of this contributes to the reduced quality of life [ 12 ] reported by those with the disease.…”

Section: Introductionmentioning

confidence: 99%

Allied health and complementary therapy usage in Australian women with chronic pelvic pain: a cross-sectional study

Malik

Sinclair

et al. 2022

BMC Women's Health

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Background Chronic pelvic pain (CPP) causes non-cyclical pelvic pain, period pain, fatigue and other painful symptoms. Current medical and surgical management strategies are often not sufficient to manage these symptoms and may lead to uptake of other therapies. Aims To determine the prevalence of allied health (AH) and complementary therapy (CM) use, the cost burden of these therapies and explore predictive factors for using allied health or complementary medicines. Materials and methods An online cross-sectional questionnaire using the WERF EndoCost tool was undertaken between February to April 2017. People were eligible to participate in the survey if they were aged 18–45, living in Australia and had chronic pelvic pain. Results From 409 responses, 340/409 (83%) of respondents reported a diagnosis of endometriosis. One hundred and five (30%) women with self-reported endometriosis, and thirteen (18%) women with other forms of CPP saw at least one AH or CM practitioner in the previous two months, with physiotherapists and acupuncturists the most common. Women who accessed CM or AH services spent an average of $480.32 AUD in the previous two months. A positive correlation was found between education and number of AH or CM therapies accessed in the past two months (p < 0.001) and between income level and number of therapists (p = 0.028). Conclusions Women with CPP commonly access AH and CM therapies, with a high out of pocket cost. The high cost and associations with income and education levels may warrant a change to policy to improve equitable access to these services.

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Medical and surgical interventions to improve the quality of life for endometriosis patients: a systematic review

Cited by 29 publications

References 91 publications

Reproductive and postsurgical outcomes of infertile women with deep infiltrating endometriosis

Reproductive and postsurgical outcomes of infertile women with deep infiltrating endometriosis

Randomized study on the effectiveness of nomegestrol acetate plus 17β-estradiol oral contraceptive versus dienogest oral pill in women with suspected endometriosis‑associated chronic pelvic pain

Allied health and complementary therapy usage in Australian women with chronic pelvic pain: a cross-sectional study

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