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Nerve-sparing laparoscopy effectively eradicates deep infiltrating endometriosis

Nerve-sparing laparoscopy effectively eradicates deep infiltrating endometriosis Nerve-sparing laparoscopy effectively eradicates deep infiltrating endometriosis
Nerve-sparing laparoscopy effectively eradicates deep infiltrating endometriosis Nerve-sparing laparoscopy effectively eradicates deep infiltrating endometriosis

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Nerve-sparing laparoscopy can become a treatment of choice as it demonstrated significant improvement in pain and functional outcomes in patients with deep infiltrating endometriosis.

According to a recent study published in the “Archives of Gynecology and Obstetrics” journal, nerve-sparing surgery is a practical approach to manage deep infiltrating endometriosis (DIE) of the posterior compartment. The strategy also improved sexual, rectal and bladder functions significantly along with satisfactory pain reduction.     

A recent assessed study by Stefano Uccella and colleagues determine a significant role of nerve-sparing intervention in managing deep infiltrating endometriosis (DIE) and related pain and other complications. Other approaches like radical eradication are related to the elevated risk of pelvic dysfunction and iatrogenic autonomic denervation. Nerve-sparing is another surgical approach. This study was conducted to determine nerve-sparing peri-operative features and postoperative functional results related to rectal, sexual, bladder functioning and pain reduction in patients with DIE.

The females with DIE nodules of the posterior compartment 4 cm ± bowel resection who were going through laparoscopic nerve-sparing eradication surgery were selected for the analysis. Visual Analogue Scale (VAS) is used to noticed pain scores before and 6 & 1 year after the surgery. The NBD, ICIQ-UISF and FSFI questionnaires were used to determine rectal, bladder and sexual functions before and six months after the treatment.

The analysis involved 34 patients; out of which 28 patients already went through a previous abdominal surgery and left 16 patients subjected to bowel resection. The pelvic pain scores six months and one year after surgery were considerably reduced to median 3, range 0–7 and 2, 0–7 and 3, 0–8 and 2, 0–7 respectively as compared to pre-operative scores ( 9, 1–10 and 3, 0–7). ICIQ-SF questionnaires showed no difference between pre- and postoperative urinary functioning. NBD scores reduced from 3.5 to 2 at six months after the treatment (p = 0.72). No self-catheterisation of the bladder was required at six month and one-year follow-up. The total FSFI scores shifted to 22.7 from 19.1 after the treatment.

Source:

Archives of Gynecology and Obstetrics

Article:

Functional outcomes of nerve-sparing laparoscopic eradication of deep infiltrating endometriosis: a prospective analysis using validated questionnaires

Authors:

Stefano Uccella et al.

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