Int J Gynaecol Obstet. 2022 Jan 7. doi: 10.1002/ijgo.14089. Online ahead of print.
ABSTRACT
OBJECTIVE: To evaluate the functional outcomes of nerve-sparing surgery for deep infiltrating endometriosis (DIE) with or without postero-lateral parametrectomy.
METHODS: A multicenter, observational, retrospective, cohort study was performed including all symptomatic women who underwent nerve-sparing laparoscopic excision of DIE and preoperative and postoperative assessment of functional outcomes through validated questionnaires between April 2019 and March 2020. Women with postero-lateral parametrial DIE (P-group) and women with no parametrial involvement (NP-group) were compared in term of preoperative and postoperative: functional outcomes related to pelvic organs assessed through validated questionnaires (KESS and GIQLI for bowel function, BFLUTS for urinary function, and FSFI for sexual function); pain symptoms at 3-month follow-up assessed through a 11-points Visual Analogue Scales (VAS) for dyschezia, dysmenorrhea, dyspareunia and chronic pelvic pain; surgical outcomes; rate of urinary voiding dysfunction at 3-month follow-up.
RESULTS: One-hundred patients were included: 69 in the P-group and 31 in the NP-group. Preoperative and postoperative values of questionnaires, pain symptoms and postoperative complications rates were comparable between the two groups, except for postoperative dyspareunia and sexual dysfunction, which were statistically higher in the P-group. Only patients in the P-group experienced urinary voiding dysfunction, but no statistical significance was reached (p=.173).
CONCLUSION: Postero-lateral parametrectomy for DIE appears associated to a higher risk of post-operative dyspareunia and sexual dysfunction.
PMID:34995374 | DOI:10.1002/ijgo.14089
