Questionnaire‐based evaluation of sexual life after laparoscopic surgery for endometriosis: a systematic review of prospective studies

摘要

Abstract Introduction Endometriosis is a benign disease that affects women of reproductive age. Laparoscopic excision of endometriotic implants is considered one of the most effective therapeutic options. The disease and its treatment can have a major impact on psychosexual well‐being but this is often overlooked as most studies focus on pain instead of sexuality in a holistic approach. The aim of this study was to review the current literature regarding the effect of laparoscopic surgery for endometriosis on quality of sexual life (Qo SL ). Material and methods Following the “Preferred Reporting Items for Systematic Reviews and Meta‐Analyses” guidelines we conducted a systematic review that involved searching PubMed and Embase databases for prospective studies evaluating the effect of laparoscopic surgery for endometriosis on Qo SL , using validated questionnaires. Results Of 357 papers, 17 were selected for full text evaluation. Twelve studies using seven different questionnaires fulfilled the inclusion criteria. All studies reported improvements in Qo SL following laparoscopic surgery for endometriosis. A meta‐analysis could not be performed due to substantial heterogeneity among the included studies arising from differences in questionnaires, follow‐up duration, stages of endometriosis, use of hormonal treatment, and missing data. Conclusions Laparoscopic excision of endometriosis can improve Qo SL . However, there is a need for randomized controlled trials based on a new validated questionnaire regarding specifically Qo SL in association with endometriosis. As sexual functioning is a complex phenomenon driven by multiple physical, psychological and social factors, Qo SL should be holistically evaluated by a team of different healthcare providers, implementing treatment programs that are individualized to each woman.