Surgery using plasma energy for deep endometriosis: A quality of life assessment

The principal objective of our study was to assess women's quality of life (QoL) after surgery for Deep Endometriosis (DE), according to the surgical technique used.

Qualitative single-center survey in the department of obstetrics and gynecology, Angers University Hospital Center, France. All women who underwent surgery for DE from January 2011 to December 2015 were contacted by phone. The Endometriosis Health Profile-5 score was used to assess QoL before and after the surgery. Fifty-two women (response rate=86%) were included and classified into 3 groups according to the surgical technique used: simple shaving, shaving exclusively or in part by plasma vaporization (plasma), and resection.

The 3 groups were comparable for surgical history, preoperative QoL score, and characteristics of endometriotic lesions (size and site). All DE symptoms and QoL scores improved significantly after the surgery, all techniques combined (P<0.01). QoL scores for women who had plasma shaving or complete resection were significantly higher than those for women with simple shaving (respectively, 375 [225-800] and 450 [-50 to 725] vs 275 [-100 to 600]; P=0.04). Self-image significantly improved only in the plasma group (P=0.03). The complete resection group had longer hospitals stays than the other groups (P=0.001), as well as a higher surgical revision rate (23% vs 0%; P=0.02).

Plasma and complete resection improved QoL similarly for women with DE, both more than shaving alone. The advantage of plasma vaporization lies in the lesser morbidity and better self-image, both better than in women with resection.