[Evolution of symptoms and quality of life of patients after surgery of digestive endometriosis].

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.