OBJECTIVE: To determine the long term response, quality of life and levels of pain following the radical excision of rectovaginal endometriosis. DESIGN: A cohort study. SETTING: A tertiary referral centre for the management of advanced endometriosis. SAMPLE: All patients who had undergone radical resection. METHODS: Case note review and patient questionnaire. MAIN OUTCOME MEASURES: Surgical complications. Overall improvement. Dysmenorrhoea, dyspareunia, dyschezia and chronic pain were measured using a visual analogue scale. Quality of life was measured using the EQ-5D questionnaire. RESULTS: Twelve radical resections were performed by laparotomy, 48 by laparoscopy. Ten patients had a hysterectomy. Forty-eight patients underwent shaving of the pre-rectal fascia, two had a disc resection of the rectum, 10 had an anterior rectal resection. Two patients required a colostomy and two needed subsequent dilation of a stenosed anastomosis. Forty-four of the first 46 patients replied. The median follow up period was 12 months (range 2 to 22 months) and 86% (38/44) reported an improvement or whom 27 (61%) had a good response (pain completely gone or greatly improved). Patients having a hysterectomy or a disc or segmental resection of the rectum reported a good response and had a normal quality of life. Quality of life scores in the study group overall were lower than the background population. CONCLUSIONS: Radical resection is an effective treatment for rectovaginal endometriosis. Hysterectomy and rectal resection were associated with a better response and quality of life.
OBJECTIVE: To determine the long term response, quality of life and levels of pain following the radical excision of rectovaginal endometriosis. DESIGN: A cohort study. SETTING: A tertiary referral centre for the management of advanced endometriosis. SAMPLE: All patients who had undergone radical resection. METHODS: Case note review and patient questionnaire. MAIN OUTCOME MEASURES: Surgical complications. Overall improvement. Dysmenorrhoea, dyspareunia, dyschezia and chronic pain were measured using a visual analogue scale. Quality of life was measured using the EQ-5D questionnaire. RESULTS: Twelve radical resections were performed by laparotomy, 48 by laparoscopy. Ten patients had a hysterectomy. Forty-eight patients underwent shaving of the pre-rectal fascia, two had a disc resection of the rectum, 10 had an anterior rectal resection. Two patients required a colostomy and two needed subsequent dilation of a stenosed anastomosis. Forty-four of the first 46 patients replied. The median follow up period was 12 months (range 2 to 22 months) and 86% (38/44) reported an improvement or whom 27 (61%) had a good response (pain completely gone or greatly improved). Patients having a hysterectomy or a disc or segmental resection of the rectum reported a good response and had a normal quality of life. Quality of life scores in the study group overall were lower than the background population. CONCLUSIONS: Radical resection is an effective treatment for rectovaginal endometriosis. Hysterectomy and rectal resection were associated with a better response and quality of life.
Authors: U Ulrich; O Buchweitz; R Greb; J Keckstein; I von Leffern; P Oppelt; S P Renner; M Sillem; W Stummvoll; R-L De Wilde; K-W Schweppe Journal: Geburtshilfe Frauenheilkd Date: 2014-12 Impact factor: 2.915
Authors: U Ulrich; O Buchweitz; R Greb; J Keckstein; I von Leffern; P Oppelt; S P Renner; M Sillem; W Stummvoll; K-W Schweppe Journal: Geburtshilfe Frauenheilkd Date: 2013-09 Impact factor: 2.915
Authors: Carlos A Souza; Luciano M Oliveira; Camila Scheffel; Vanessa K Genro; Virginia Rosa; Marcia F Chaves; João S Cunha Filho Journal: Health Qual Life Outcomes Date: 2011-06-10 Impact factor: 3.186
Authors: M Chassang; S Novellas; C Bloch-Marcotte; J Delotte; O Toullalan; A Bongain; P Chevallier Journal: Eur Radiol Date: 2009-10-28 Impact factor: 5.315