Measured Symptomatic and Fertility Outcomes in Women Undergoing Laparoscopic Surgery for Mild and Moderate Endometriosis: A Prospective Study

摘要

OBJECTIVE: To evaluate the effectiveness of laparoscopic surgery in relieving patient’s symptoms due to mild and moderate endometriosis.STUDY DESIGN: Qausi experimental study (pre-test post-test design).PLACE AND DURATION: Maroof International Hospital Islamabad from 1st January 2014 to 30th December 2016.METHODOLOGY: The study was conducted on 35 patients who underwent laparoscopic surgery for mild to moderateendometriosis. These symptoms include infertility, chronic pelvic pain, dysmenorrhea, dyspareunia and dyschezia.They all filled a visual analogue scale (VAS) questionnaire for four symptoms of endometriosis prior to surgery andwere followed three to six months after surgery by again filling up the VAS questionnaire and clinical evaluation.RESULTS: Mean age at surgery was 30.05 (4.41; 21-38) years. Primary symptom was dysmenorrhea in 62.8%, pelvic pain notrelated to menstruation in 28.5%, dyspareunia in 11.4% and dyschezia in 8.5% of patients. There was primary subfertilityin 28.5% and secondary subfertility in 5.71% patients. At surgery endometriosis was diagnosed as stage II in 28.5%, and stageIII in 71.4 %. Laparoscopic ablation and excision of endometriotic implants was done in all cases and excision of cysts wasperformed in 65.7% cases. All the four pain scores were reduced with statistically significant difference, 3 patients out of 12patients of infertility conceived during follow up period. There was histologic evidence of endometriosis in 85.7% patients.CONCLUSION: Laparoscopic excision of endometriosis significantly reduces pain related symptoms whenmeasured by visual analogue scale and improves fertility in patients with mild and moderate endometriosis.