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Endometriosis Resection Using Nerve Sparing Versus Non-nerve Sparing Surgical Techniques.

Shailesh P Puntambekar1, Sneha Venkateswaran1, Saranya Naidu1

  • 1Galaxy Care Laparoscopy Institute, Pune, India.

Journal of Obstetrics and Gynaecology of India
|November 2, 2023
PubMed
Summary

Nerve sparing surgery for endometriosis improves urinary and sexual function post-operation. This technique, by preserving pelvic nerves, enhances quality of life without impacting long-term survival outcomes.

Keywords:
EndometriosisHypogastric plexusLaparoscopyNerve sparing

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Area of Science:

  • Gynecology
  • Surgical Oncology
  • Pelvic Surgery

Background:

  • Endometriosis involves ectopic endometrial tissue outside the uterus.
  • Nerve-sparing techniques in oncology improve quality of life post-surgery.
  • The impact on quality of life regarding sexual and urinary function after endometriosis surgery is under-investigated.

Purpose of the Study:

  • To compare the quality of life, specifically sexual and urinary function, between women undergoing nerve-sparing surgery and those undergoing non-nerve-sparing surgery for endometriosis.

Main Methods:

  • Data from 51 endometriosis patients operated between January 2020 and December 2020 were analyzed.
  • Patients aged 38-44 with moderate to severe endometriosis (r-ASRM score ≥16) undergoing hysterectomy with additional procedures were included.
  • Evaluations included operative factors, complications, and postoperative urinary and sexual function assessed via follow-up visits and interviews.

Main Results:

  • Patients undergoing nerve-sparing surgeries demonstrated significantly better urinary and sexual function compared to those who underwent non-nerve-sparing surgeries.
  • No compromise in long-term survival was implied by the adoption of nerve-sparing techniques.

Conclusions:

  • A laparoscopic nerve-sparing approach for endometriosis clearance leads to an improved quality of life post-surgery.
  • A thorough understanding of pelvic neuroanatomy makes this approach feasible for selected patients.