Evolution of symptoms and quality of life of patients after surgery of digestive endometriosis [évolution des sympt?mes et de la qualité de vie des patientes après chirurgie de l'endométriose digestive]

摘要

Objectives Prospective evaluation of symptoms and quality of life before and after surgical treatment of endometriosis with bowel involvement. Patients and methods Changes in symptoms, sexuality and quality of life before and after surgery of 41 patients operated for bowel endometriosis at the centre hospitalier de Versailles (CHV) were assessed with a self-assessment questionnaire. Pains were assessed using five visual analog scales, symptoms using 26 questions with a four-level Likert item, sexuality using the SEXACQ, and quality of life using the EHP-5 and the EQ-5D VAS. Results Surgical treatment improves pain: VAS scores for main pain (P < 0.0001), dysmenorrhea (P = 0.0039), defecation pain (P = 0.0312), non-cyclic pelvic pain (P = 0.0002), and dyspareunia (P = 0.0084). Twelve intestinal symptoms are improved, including three significantly. It also improves SEXACQ score (P = 0.0068) and quality of life scores EHP-5 and EQ-5D VAS (P = 0.0001 and P = 0.0003 respectively). No difference was found between disk resection and segmental resection in terms of symptoms, sexuality and quality of life. Histological analysis suggests that when a segmental resection is done, the stage of the endometriosis bowel involvement is more advanced. Discussion and conclusion Surgery of bowel endometriosis improves symptoms and quality of life. When the stage of the bowel endometriosis is advanced, a segmental resection should be done. Moreover, self-assessment questionnaire used at the CHV seems an appropriate tool to evaluate functional outcome.