Long-term Follow-up of Sexual Quality of Life after Laparoscopic Surgery in Patients with Deep Infiltrating Endometriosis

María-Angeles Martínez-Zamora,José Luis Coloma,Meritxell Gracia,Mariona Rius,Camil Castelo-Branco,Francisco Carmona

doi:10.1016/j.jmig.2021.04.023

Abstract

We performed a long-term follow-up to quantify the impairment of sexual quality of life (SQL) and health-related QL (HRQL) in sexually active women after laparoscopic excision of deep infiltrating endometriosis (DIE). Prospective case-control study. Hospital Clinic of Barcelona. A total of 193 patients (after dropout and exclusions) were divided into 2 groups: one hundred twenty-nine premenopausal women with DIE (DIE group) and 64 healthy women who underwent tubal ligation (C group). All patients underwent laparoscopic surgery: laparoscopic endometriosis surgery in the DIE group and laparoscopic tubal ligation in the C group. All women were followed for at least 36 months, and they completed the Medical Outcomes Study 36-item short form questionnaire to assess their HRQL and 3 self-administered questionnaires that evaluate different aspects of SQL: the generic Sexual Quality of Life-Female questionnaire, the Female Sexual Distress Scale to evaluate "sexually related distress," and the Brief Profile of Female Sexual Function to screen hypoactive sexual desire disorder. The patients with DIE as well as the controls completed the 4 questionnaires before surgery, and the patients with DIE also completed the questionnaires at 6 and 36 months after surgery. A comparison of the patients and controls before surgery showed a statistically significant impairment in SQL and HRQL among the patients with DIE. A statistically significant improvement in SQL and HRQL was observed in the DIE group 6 months after surgery, with scores being similar to those of the C group. An evaluation 36 months after surgery showed that SQL and HRQL were better than presurgical SQL and HRQL in the DIE group, with a slight reduction compared with the 6-month evaluation. SQL and HRQL improved in patients with DIE undergoing complete laparoscopic endometriosis resection and were comparable to those of healthy women at 6 months after surgery, showing a slight reduction at 36 months of follow-up.

Highlights

Sexual health is a critical aspect of health-related quality of life (HRQL) and is influenced by medical conditions, especially when gynecologic disorders are involved [1]
Some authors have demonstrated that sexual QL (SQL) is negatively influenced by endometriosis [15,16], especially by the symptoms of dyspareunia and chronic pelvic pain presented by patients with endometriosis [17]
Different hormonal or surgical treatments of endometriosis seem to have a positive impact on SQL [15,17,18], few studies have been carried out in patients with deep infiltrating endometriosis (DIE), and most are short-term ones [7−14]

Summary

Introduction

Sexual health is a critical aspect of health-related quality of life (HRQL) and is influenced by medical conditions, especially when gynecologic disorders are involved [1]. Endometriosis is one of the most common gynecologic diseases during the reproductive years of women. The. Martınez-Zamora et al Long-term Sexual Quality of Life after Laparoscopic Surgery for Deep Infiltrating Endometriosis diseases and dysfunctions could have a significant impact on public health [5,6]. Some authors have demonstrated that sexual QL (SQL) is negatively influenced by endometriosis [15,16], especially by the symptoms of dyspareunia and chronic pelvic pain presented by patients with endometriosis [17].

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Conclusion