Functional outcomes of nerve-sparing laparoscopic eradication of deep infiltrating endometriosis: a prospective analysis using validated questionnaires

2018 ◽  
Vol 298 (3) ◽  
pp. 639-647 ◽  
Author(s):  
Stefano Uccella ◽  
Baldo Gisone ◽  
Maurizio Serati ◽  
Sara Biasoli ◽  
Nicola Marconi ◽  
...  
2022 ◽  
Author(s):  
Carlo Alboni ◽  
Veronica Sampogna ◽  
Mirvana Airoud ◽  
Stefania Malmusi ◽  
Antonino Farulla ◽  
...  

Abstract Objective: Complete eradication of parametrial nodules of Deep Infiltrating Endometriosis (DIE) is associated with a high risk of iatrogenic nerves damage and pelvic organs dysfunction. The aim of this study is to evaluate via validated questionnaires the effect of laparoscopic excision of parametrial DIE on quality of life as first outcome and on pain symptoms and post- operative voiding function (bladder and rectal) as secondary outcome.Study design: All patients undergoing laparoscopic excision of posterior or lateral parametrial DIE by a single expert surgeon between January 2013 and March 2017 were included in the study. A nerve-sparing approach was adopted in all patients. Quality of life (QoL) and Functional outcomes were evaluated using validated questionnaires (EHP-30 for the health profile, NBD score for intestinal function, ICIQ-FLUTS for urinary function), administered preoperatively and after surgery. Pain scores were collected before and after surgery using Visual Analogue Scale (VAS).Results: During the study period a total of fifty-nine patients met the inclusion criteria. Fifty-one patients agreed to fill out questionnaires for post-operative outcomes. EHP-30 scores had a significant improvement in all the domains analyzed even in the relationship with children and fertility module despite to the small number of patients answering those questions. No differences were found in terms of urinary function between pre and post-operative questionnaires (ICIQ-FLUTS). Bowel function improved in patients’ subjective perception. The NBD score showed that intestinal dysfunction related only to constipation and was reported as very minor by 76.4% of patients, minor by 11.8%, moderate by 5.9% by and severe by 5.95% of patients. Pain symptoms (VAS score) decreased significantly after surgery with the exception of chronic pelvic pain. (p value < 0,05). Conclusions: Laparoscopic nerve-sparing radical excision of parametrial DIE is safe and effective when performed by an expert surgical equipe. This approach can favorably impact on patients QoL. Moreover, it has proved to result in pain score and voiding function improvements.


2015 ◽  
Vol 36 (1) ◽  
pp. 57-61 ◽  
Author(s):  
José Anacleto Dutra de Resende ◽  
Luciana Tricai Cavalini ◽  
Claudio Peixoto Crispi ◽  
Marlon de Freitas Fonseca

2010 ◽  
Vol 284 (1) ◽  
pp. 131-135 ◽  
Author(s):  
A. Kavallaris ◽  
C. Banz ◽  
N. Chalvatzas ◽  
A. Hornemann ◽  
D. Luedders ◽  
...  

2015 ◽  
Vol 156 (48) ◽  
pp. 1960-1965
Author(s):  
Attila Bokor ◽  
Noémi Csibi ◽  
Péter Lukovich ◽  
Réka Brubel ◽  
József Gábor Joó ◽  
...  

Introduction: Traditional surgeries performed in cases of deep infiltrating endometriosis lead to impaired quality of life. Aim: To summarize the postoperative outcome and to compare the rate of postoperative complications after different therapeutic approaches applied in deep infiltrating endometriosis. Method: The authors analized the articles published between March 31, 2004 and March 31, 2015, in the database http://www.pubmed.org using the following keywords: endometriosis, deep infiltrating, nerve sparing, surgery. Results: Non-nerve sparing surgery resulted in temporary urinary dysfunction in 19.1–38.5% of patients, while it occurred in 0.61–33.3% of patients after nerve-sparing surgery. Non-nerve sparing surgical technique resulted in an avarage of 121 days of need for self-catheretisation. When nerve-sparing surgeries were performed the duration of self-catheterisation varied between 7 to 39.8 days. After nerve sparing surgeries, permanent bladder dysfunction was not detected in any case. Conclusions: Because of the successful treatment of the patients symptoms and the lower postoperative complication rate, nerve-sparing surgical technique leads to a significant improvement of the quality of life. Orv. Hetil., 2015, 156(48), 1960–1965.


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