Segmental Rectum Resection for Deep Endometriosis and Excision Similarly Improve Sexual Function and Pain.

Area of Science:

• Gynecologic Surgery
• Reproductive Medicine
• Sexual Health

Background:

• Previous studies indicate significant sexual dysfunction after rectal resections for non-endometriosis indications.
• Deep endometriosis often necessitates surgical intervention, potentially impacting adjacent organs like the bowel.

Purpose of the Study:

• To compare sexual function outcomes between low bowel resection and conservative excision for deep endometriosis.
• To identify factors influencing sexual function post-surgery in endometriosis patients.

Main Methods:

• Prospective evaluation of 56 patients with deep endometriosis undergoing either low bowel resection (n=33) or conservative excision (n=23).
• Assessment of sexual function using the Female Sexuality Functioning Index (FSFI-19) and Endometriosis Health Profile (EHP 30).
• Pain evaluation via visual analogue scales; statistical analysis using univariate and multivariate models.

Main Results:

• Both linear excision and bowel resections demonstrated comparable improvements in FSFI, EHP 30 scores, and postoperative pain.
• Preoperative and postoperative pain, age, and duration of surgery were associated with decreased sexual function in univariate analysis.
• Multivariate analysis indicated that FSFI scores post-surgery were predicted by preoperative FSFI or postoperative EHP scores.

Conclusions:

• Surgical improvement in pain is a significant factor in enhancing sexual function for women with endometriosis.
• Low bowel resection for deep endometriosis did not result in a deleterious effect on sexual function compared to conservative excision.
• Simplified questionnaires like the FSFI-6 can effectively evaluate sexual function in women with endometriosis.