Pelvic Pain and Quality of Life Before and After Laparoscopic Bowel Resection for Rectosigmoid Endometriosis: A
Mads Riiskjær1, Axel Forman1, Ulrik S Kesmodel2
1Department of Obstetrics and Gynecology, Aarhus University Hospital, Denmark.
Background:
Surgery for rectosigmoid endometriosis carries a substantial risk of short- and long-term complications, which has to be counterbalanced against the potential effect of the procedure. Prospective data are scarce in the field of deep infiltrating endometriosis surgery.
Objective:
The study aimed to assess pelvic pain and quality of life before and after laparoscopic bowel resection for rectosigmoid endometriosis.
Design:
The study involved prospectively collected data regarding pelvic pain and quality of life before and after surgery.
Settings:
It was conducted at a tertiary endometriosis referral unit at Aarhus University Hospital.
Patients:
A total of 175 women were included.
Intervention:
Patients underwent laparoscopic bowel resection for endometriosis.
Main Outcome Measures:
Questionnaires for pain (Numerical Rating Scale) and quality of life (RAND Short Form-36) were answered before and 1 year after surgery. Data on analgesic and hormone treatment were collected. Preoperative and postoperative pelvic pain and quality-of-life scores were compared, and risk factors for improvement/worsening were identified.
Results:
A total of 97.1% of the women completed the 1-year follow up. A significant decrease (p = 0.0001) was observed on all pelvic pain parameters. Most profound was the decrease in dyschezia. A significant improvement on all quality-of-life scores was observed (p = 0.0001). A surgical complication did not have a negative impact on outcome 1 year after surgery. The postoperative outcome was not related to the type of surgery.
Limitations:
This is an observational study without a control group. Risk factor data should be interpreted with caution, because the study was relatively underpowered for some of the rare outcomes.
Conclusions:
A significant and clinically relevant improvement in pelvic pain and quality of life 1 year after laparoscopic bowel resection for endometriosis was found. We strongly recommend surgery for rectosigmoid endometriosis that is unresponsive to conservative treatment. See Video Abstract at http://links.lww.com/DCR/A472.
Related Concept Videos
01:11Observational Studies
There are three types of observational studies – Prospective, retrospective, and cross-sectional.
Prospective Study
Prospective studies, also known as longitudinal or cohort studies, are carried out by collecting future data from groups sharing similar characteristics. One...
02:30Naturalistic Observations
02:42Half-life of a Reaction
01:23Characteristics of Life
02:39The Angiosperm Life Cycle
02:40The Tree of Life - Bacteria, Archaea, Eukaryotes