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Radical destruction of deep infiltrating endometriosis (DIE) is linked with a high risk of pelvic dysfunction and iatrogenic autonomic denervation.
Deep endometriosis is a severe pain condition in which the abnormal endometrium invades the peritoneum up to >5 mm. It is one of the most common disorders that affect the girls. Laparoscopic nerve-sparing surgery is the approach that can be used to provide relief from the problem and related pain. The study involves the evaluation of evidence that governs the approach efficacy.
Radical destruction of deep
infiltrating endometriosis (DIE) is linked with a high risk of pelvic
dysfunction and iatrogenic autonomic denervation. The study aimed to
investigate peri-operative details prospectively, and postoperative functional
results amidst the women went through DIE treatment of the posterior
compartment with nerve-sparing technique, using the validated questionnaires
and visual analogue scale (VAS).
Thirty four women went through laparoscopic nerve-sparing eradicative surgery were involved in the analysis. The pain scores were noticed before, at six months and one year postoperatively. The NBD score, FSFI and ICIQ-UISF were used to measure functional outcomes; rectal, sexual function and bladder respectively before and six months postoperatively.
A total of 16 patients went through bowel resection. Twenty-eight already went through an abdominal surgery for endometriosis previously. As compared to pre-operative levels, VAS score levels considerably reduced 6 months and one year postoperatively (p < 0.0001). ICIQ-UISF questionnaires exhibited no difference between pre- and postoperative scores. No case required bladder self-catheterisation at six months and one-year follow-up. The NBD and FSFI scores observed pre- and postoperatively were 3.5 vs. 2 and 19.1 vs. 22.7, respectively.
The nerve-sparing approach is efficient in eliminating DIE of the posterior compartment, maintenance of bladder and rectal function, significant sexual function and satisfactory pain control.
Archives of Gynecology and Obstetrics
Functional outcomes of nerve-sparing laparoscopic eradication of deep infiltrating endometriosis: a prospective analysis using validated questionnaires
Stefano Uccella et al.
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