Xuan Che1, Xiufeng Huang2, Jing Zhang2, Hong Xu2, Xinmei Zhang3. 1. Jiaxing Maternity and Child Health Care Hospital, Jiaxing, Zhejiang 314050, PR China. 2. Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310006, PR China. 3. Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310006, PR China. Electronic address: zxm20130729@163.com.
Abstract
OBJECTIVE: To investigate the efficacy of nerve-sparing surgery for deeply infiltrating endometriosis (DIE) and the bladder and sexual dysfunction that follow this procedure. STUDY DESIGN: A total of 108 women with DIE underwent conventional surgery (group A, n=63) and nerve-sparing surgery (group B, n=45). Three validated interview-based questionnaires - the visual analogue scale (VAS), the international prostate score symptom (IPSS), and the female sexual function index (FSFI) - were used to evaluate the efficacy and associated complications. RESULTS: The VAS scores significantly decreased in both groups A and B after surgery, although two patients (4.4%) in group B had no improvement in their pain symptoms. The total FSFI and each domain scores significantly increased in the two groups after surgery except for satisfaction at the 24-month follow up in group A. Nine patients (15.9%) in group A required self-catheterization postoperatively. Based on the IPSS scores, a significant alteration in voiding symptoms in group A was observed at 6 months but not at 12 months or 24 months after surgery. In group B, however, no significant difference or self-catheterization requirement was observed after surgery. CONCLUSIONS: Reduced bladder and sexual dysfunction, but with a risk of absence of pain relief, suggests that the pros and cons of nerve-sparing surgery for DIE should carefully be evaluated before operation.
OBJECTIVE: To investigate the efficacy of nerve-sparing surgery for deeply infiltrating endometriosis (DIE) and the bladder and sexual dysfunction that follow this procedure. STUDY DESIGN: A total of 108 women with DIE underwent conventional surgery (group A, n=63) and nerve-sparing surgery (group B, n=45). Three validated interview-based questionnaires - the visual analogue scale (VAS), the international prostate score symptom (IPSS), and the female sexual function index (FSFI) - were used to evaluate the efficacy and associated complications. RESULTS: The VAS scores significantly decreased in both groups A and B after surgery, although two patients (4.4%) in group B had no improvement in their pain symptoms. The total FSFI and each domain scores significantly increased in the two groups after surgery except for satisfaction at the 24-month follow up in group A. Nine patients (15.9%) in group A required self-catheterization postoperatively. Based on the IPSS scores, a significant alteration in voiding symptoms in group A was observed at 6 months but not at 12 months or 24 months after surgery. In group B, however, no significant difference or self-catheterization requirement was observed after surgery. CONCLUSIONS: Reduced bladder and sexual dysfunction, but with a risk of absence of pain relief, suggests that the pros and cons of nerve-sparing surgery for DIE should carefully be evaluated before operation.
Authors: Manuel Maria Ianieri; Diego Raimondo; Andrea Rosati; Laura Cocchi; Rita Trozzi; Manuela Maletta; Antonio Raffone; Federica Campolo; Giuliana Beneduce; Antonio Mollo; Paolo Casadio; Ivano Raimondo; Renato Seracchioli; Giovanni Scambia Journal: Int J Gynaecol Obstet Date: 2022-01-20 Impact factor: 4.447