scholarly journals Impact on Quality of Life of Laparoscopic Nerve-sparing Radical Treatment of Parametrial Deep Infiltrating Endometriosis (Postoperative Pain Assessment and Functional Outcomes)

2022 ◽  
Author(s):  
Carlo Alboni ◽  
Veronica Sampogna ◽  
Mirvana Airoud ◽  
Stefania Malmusi ◽  
Antonino Farulla ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Functional Outcomes ◽  
Nerve Sparing ◽  
Deep Infiltrating Endometriosis ◽  
Urinary Function ◽  
Voiding Function ◽  
Validated Questionnaires ◽  
Laparoscopic Excision ◽  
Pain Symptoms

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.

scholarly journals Az idegkímélő műtéti technika jelentősége a mélyen infiltráló endometriosis sebészetében

2015 ◽  
Vol 156 (48) ◽  
pp. 1960-1965
Author(s):  
Attila Bokor ◽  
Noémi Csibi ◽  
Péter Lukovich ◽  
Réka Brubel ◽  
József Gábor Joó ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Technique ◽  
Postoperative Outcome ◽  
Nerve Sparing ◽  
Deep Infiltrating Endometriosis ◽  
Therapeutic Approaches ◽  
Keywords Endometriosis ◽  
Impaired Quality ◽  
Infiltrating Endometriosis

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.

scholarly journals Quality of Life Following Prostatectomy as a Function of Surgery Type and Degree of Nerve Sparing

2017 ◽  
Vol 11 (1) ◽  
pp. 16-20 ◽  
Author(s):  
Donald S. Strassberg ◽  
Suzanne M. Zavodni ◽  
Paul Gardner ◽  
Christopher Dechet ◽  
Robert A. Stephenson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Sexual Functioning ◽  
Nerve Sparing ◽  
Urinary Function ◽  
Robotic Assisted ◽  
Multiple Measures ◽  
Post Surgery ◽  
Retropubic Radical Prostatectomy ◽  
Urinary Functioning

Objectives: To compare robotic-assisted laparoscopic prostatectomy with conventional retropubic radical prostatectomy in maintaining pre-surgery levels of urinary and sexual functioning and to evaluate the efficacy of nerve sparing in prostatectomies in protecting urinary functioning. Material and Methods: Patients (n = 385) receiving both surgical procedures were surveyed prior to surgery. Multiple measures, including the Expanded Prostate Cancer Index Composite, the Sexual Health Inventory for Men, and the International Prostate Symptom Score, assessed sexual and urinary function at an average of 12 months post-surgery. Results: Across multiple measures, while controlling for pre-surgical sexual functioning, robotic-assisted surgery did not offer an advantage in maintaining sexual or urinary function an average of a year following the prostatectomy. Bilateral nerve sparing offered a strong and reliable advantage in the maintenance of sexual function, but not so regarding urinary function. Conclusion: While robotic-assisted prostatectomies may offer a number of medical advantages over open procedures, we found no significant effect on important quality of life outcomes associated with the technique.

Nerve-sparing Prostatectomy and Urinary Function: A Prospective Analysis Using Validated Quality-of-life Measures

Urology ◽  
2009 ◽  
Vol 73 (6) ◽  
pp. 1336-1340 ◽  
Author(s):  
E. Jason Abel ◽  
Timothy A. Masterson ◽  
Jonathan N. Warner ◽  
Karen Valentine ◽  
Christopher Dechet
Keyword(s):  
Quality Of Life ◽  
Nerve Sparing ◽  
Prospective Analysis ◽  
Urinary Function ◽  
Quality Of Life Measures

scholarly journals Nightly sildenafil use after radical prostatectomy has adverse effects on urinary convalescence: Results from a randomized trial of nightly vs on-demand dosing regimens

2015 ◽  
Vol 9 (11-12) ◽  
pp. 414 ◽  
Author(s):  
Matthew Eric Hyndman ◽  
Trinity J Bivalacqua ◽  
Zhaoyong Feng ◽  
Lynda Z Mettee ◽  
Li-Ming Su ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Radical Prostatectomy ◽  
Randomized Trial ◽  
Nerve Sparing ◽  
Health Related Quality ◽  
Urinary Function ◽  
On Demand ◽  
Related Quality ◽  
Health Related

<p><strong>Introduction:</strong> This is a report on urinary function results from a randomized trial of nightly versus on-demand sildenafil after nerve-sparing radical prostatectomy (RP), a secondary objective. We analyzed the effects of these sildenafil administration schemes on urinary health-related quality of life after RP.</p><p><strong>Methods:</strong> In total, 100 potent men were equally randomized to nightly and on-demand sildenafil 50 mg after minimally-invasive RP for 1 year. Health-related quality of life questionnaires were administered at various postoperative intervals. Urinary function was assessed using appropriate expanded prostate cancer index composite (EPIC) subscales. Analyses of covariance and linear mixed-effects modeling were used to compare the effects of treatment over time on urinary recovery, controlling for age, nervesparing score, and time from surgery.</p><p><strong>Results:</strong> The nightly (n = 50) and on-demand (n = 50) sildenafil groups were well-matched at baseline. Nightly sildenafil patients had worse EPIC urinary bother and urinary irritative/obstructive subscale scores at 3 and 6 months after RP, even after controlling for multiple variables. On mixed-model analyses, the differences between groups for these EPIC subscales (4.9 and 2.5, respectively) were greater than documented thresholds for clinical significance. Increasing nerve-sparing score was associated with improvements in EPIC urinary summary, bother, incontinence, and function scores; time from surgery was associated with improvements in all EPIC urinary health-related quality of life subscales.</p><p><strong>Conclusions:</strong> In this specific population and drug dose, we found that on-demand short-acting phosphodiesterase-5 inhibitor (PDE5i) dosing may be more effective after RP to maximize early urinary health-related quality of life. In preoperatively potent men, nightly sildenafil 50 mg impaired urinary health-related quality of life more than on-demand use in the early months after nerve-sparing RP, independent of effects on urinary continence.</p>

219: Functional Outcomes and Quality of Life Following Laparoscopic Radical Prostatectomy: Prospective Analysis Over a 4-Year Experience

2006 ◽  
Vol 175 (4S) ◽  
pp. 72-72
Author(s):  
Andrew A. Wagner ◽  
Richard E. Link ◽  
Aron Sulman ◽  
Wendy Sullivan ◽  
Christian P. Pavlovich ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Radical Prostatectomy ◽  
Functional Outcomes ◽  
Laparoscopic Radical Prostatectomy ◽  
Prospective Analysis

145: Urinary Function Quality of Life After Laparoscopic or Robotic Assisted Radical Prostatectomy

2004 ◽  
Vol 171 (4S) ◽  
pp. 38-38
Author(s):  
Laura E. Crocitto ◽  
Timothy Wilson ◽  
Jeffrey S. Yoshida ◽  
Soroush A. Ramin ◽  
Mark H. Kawachi
Keyword(s):  
Quality Of Life ◽  
Radical Prostatectomy ◽  
Urinary Function ◽  
Robotic Assisted ◽  
Robotic Assisted Radical Prostatectomy
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