Functional outcomes of nerve-sparing laparoscopic eradication of deep infiltrating endometriosis

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SCIENCE
Functional outcomes of nerve-sparing laparoscopic eradication of deep infiltrating endometriosis
Key Take-Away: 

Deep endometriosis is the severe pain condition in which the abnormal endometrium invade the peritoneum up to >5 mm is one of the most common disorders affects 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.

Introduction
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).

 

Methods
A total of 34 women went through laparoscopic nerve-sparing eradicative surgery were involved in the analysis. The pain scores were noticed before and 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.

 

Results
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 notice pre- and postoperatively was 3.5 vs 2 and 19.1 vs 22.7, respectively.

 

Conclusions
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.

Source:

Archives of Gynecology and Obstetrics

Link to the source:

https://link.springer.com/article/10.1007%2Fs00404-018-4852-z

Original title of article:

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

Authors:

Stefano Uccella et al.

Therapeutic, Endometriosis, Uterus, Prospective Study, Efficacy, VAS, ICIQ-UISF, NBD, FSFI
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