Клиническая эффективность хирургического лечения эндометриоза I–II cтадии по rASRM

Abstract

Abstract Aim. To assess the dynamics of clinical symptoms of endometriosis I–II stage (R-AFS classification) in patients with infertility before and after surgical treatment. Design. Retro-prospective cohort study. Materials and methods. The study included 55 women aged 25 to 43 years with a diagnosis of infertility and the presence of external genital endometriosis I-II stage (R-AFS classification) according to laparoscopic surgery, performed for diagnostic and therapeutic purposes. The dynamics of the pain syndrome were assessed based on the study of the pelvic pain intensity by the visual analogue scale (VAS) — from 0 to 10 points. The dynamics of clinical symptoms of the disease were assessed 12–36 months after surgical treatment using a questionnaire. A comparison was made of the data obtained during surgical treatment with the clinical manifestations of the disease. Results. Data analysis revealed a decrease in the frequency of dysmenorrhea in 16 (29.1%) women (p = 0.002) and a decrease in its intensity in 39 (70.9%) women (p < 0.001), the disappearance of chronic pelvic pain (CPP) in 10 (18.2%) women (p = 0.014) and a decrease in its intensity in 17 (30.9%) women (p = 0.011), as well as a decrease in the frequency of dyspareunia in 6 (10.9%) cases (p = 0.046). The study did not reveal a statistically significant difference in the dynamics of some menstrual cycle characteristics (regularity, abundance, presence of spotting before menstruation) before and after surgery. The relationship between CPP, dysmenorrhea and dyspareunia and the localization of endometriotic lesions has not been established. It was also not found any dependence of the surgical intervention type and the presence of pain symptoms of endometriosis. Conclusion. The surgical method is the optimal tool for treating endometriosis in the presence of objective indications: severe pain, ineffectiveness or impossibility of conservative therapy. Key words: external genital endometriosis, surgical treatment of endometriosis, laparoscopy, pain, infertility.