Is nerve-sparing surgery suitable for deeply infiltrating endometriosis?

详细信息    查看全文

• 作者：Xuan Che² ; Xiufeng Huang¹ ; Jing Zhang¹ ; Hong Xu¹ ; Xinmei Zhang¹ ; ^{zxm20130729@163.com" class="auth_mail}
• 关键词：Deeply infiltrating endometriosis ; Visual analogue scale ; Nerve-sparing surgery ; International prostate score symptom ; Female sexual function index
• 刊名：European Journal of Obstetrics and Gynecology and Reproductive Biology
• 出版年：April, 2014
• 年：2014
• 卷：175
• 期：Complete
• 页码：87-91
• 全文大小：300 K

文摘

Objective

To investigate the efficacy of nerve-sparing surgery for deeply infiltrating endometriosis (DIE) and the bladder and sexual dysfunction that follow this procedure.

Study design

A total of 108 women with DIE underwent conventional surgery (group A, n = 63) and nerve-sparing surgery (group B, n = 45). Three validated interview-based questionnaires - the visual analogue scale (VAS), the international prostate score symptom (IPSS), and the female sexual function index (FSFI) - were used to evaluate the efficacy and associated complications.

Results

The VAS scores significantly decreased in both groups A and B after surgery, although two patients (4.4%) in group B had no improvement in their pain symptoms. The total FSFI and each domain scores significantly increased in the two groups after surgery except for satisfaction at the 24-month follow up in group A. Nine patients (15.9%) in group A required self-catheterization postoperatively. Based on the IPSS scores, a significant alteration in voiding symptoms in group A was observed at 6 months but not at 12 months or 24 months after surgery. In group B, however, no significant difference or self-catheterization requirement was observed after surgery.

Conclusions

Reduced bladder and sexual dysfunction, but with a risk of absence of pain relief, suggests that the pros and cons of nerve-sparing surgery for DIE should carefully be evaluated before operation.