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

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.