Is nerve-sparing surgery suitable for deeply infiltrating endometriosis?

Area of Science:

• Gynecology
• Surgical Innovation
• Pelvic Health

Background:

• Deeply infiltrating endometriosis (DIE) significantly impacts women's quality of life.
• Surgical interventions for DIE aim to improve symptoms and function.
• Nerve-sparing techniques are explored to minimize postoperative dysfunction.

Purpose of the Study:

• To assess the effectiveness of nerve-sparing surgery for DIE.
• To evaluate the impact of this surgery on bladder and sexual dysfunction.
• To compare outcomes with conventional surgical approaches.

Main Methods:

• 108 women with DIE underwent either conventional surgery (n=63) or nerve-sparing surgery (n=45).
• Validated questionnaires (VAS, IPSS, FSFI) assessed pain, voiding symptoms, and sexual function.
• Outcomes were evaluated at multiple follow-up points.

Main Results:

• Both surgical groups showed reduced pain (VAS) and improved sexual function (FSFI).
• Nerve-sparing surgery (Group B) demonstrated no significant impact on voiding symptoms or need for self-catheterization.
• Conventional surgery (Group A) showed temporary voiding alterations and a higher rate of self-catheterization requirement.

Conclusions:

• Nerve-sparing surgery for DIE effectively reduces bladder and sexual dysfunction.
• A small risk of persistent pain exists, necessitating careful pre-operative consideration.
• The benefits of nerve-sparing surgery warrant careful evaluation against potential drawbacks.