Assessment of the rehabilitation programs effectiveness in patients with painful external genital endometriosis

Abstract

In patients with a painful form of external genital endometriosis (EGE), the prevailing symptom is chronic pelvic pain, which significantly reduces the quality of life (QoL). It causes disorders of the physical, psycho-emotional and sexual health of women of reproductive age, leading to distress, maladaptation, anxiety-depressive disorders, disruption of social functioning and family relationships. Objective. To evaluate the effectiveness of the rehabilitation program for women with a painful form of EGE after radical treatment in the rehabilitation period. Materials and methods. In the examined cohort were included a total of 104 patients of reproductive age 42.4±3.7 years with a painful form of EGE after radical treatment: Group 1 – 49 women with "active" rehabilitation; Group 2 – 55 patients with "passive" rehabilitation tactics in accordance with standards and National Clinical Guidelines. Integral assessment of QoL (objective) was performed using clinical, laboratory (cancer antigen-125 (CA-125), cancer antigen-19.9 (CA-19.9), interleukin-6 (IL-6), tumor necrosis factor (TNF), femoflor – 16, pH-metric titration), and instrumental studies (ultrasound, magnetic resonance imaging (MRI)). At the control points: before, in 5–9 days, 1,3,6 and 12 months after surgical treatment. Results. Patients with "active" rehabilitation tactics (Group 1) had a significantly more pronounced decrease in the levels of the assessed biomarkers in blood serum, normalization of the urogenital tract microbiocenosis and restoration of pelvic organs and structures, unlike patients in the comparison group. Conclusion. The use of comprehensive personalized rehabilitation in patients with painful form of EGE after radical treatment has demonstrated its effectiveness. Widespread introduction of rehabilitation programs into routine clinical practice is necessary.