Abstract
Morbidity and mortality alone are not comprehensive measures of evaluating the benefits of surgical interventions in endometriosis patients, thus, subjective patient-reported instruments are required. The 36-tem Short Form Survey (SF-36) is a Health-Related Quality of Life (HRQoL) instrument that has not been validated yet for women with endometriosis. The aims of this study are to evaluate the validity and reliability of the SF-36 in patients with colorectal endometriosis and to compare the HRQoL before and after surgery, using different Quality of Life (QoL) instruments: the Gastrointestinal QoL Index (GIQLI) and Knowles–Eccersley–Scott Symptom Questionnaire (KESS). We conducted a retrospective study using prospectively recorded data in the North-West Inter-Regional Female Cohort for Patients with Endometriosis (CIRENDO) database. The assessment was performed on four hundred and eighty-eight patients before and 12 months after the surgery. Preoperative and postoperative item-internal consistency and Cronbach’s α proved evidence for good reliability showing that SF-36 is a useful instrument for endometriosis patients’ QoL. The domains of Role (limitation) physical, Bodily pain and Role (limitation) emotional showed the most remarkable improvements (difference before vs. one year after surgery) with p < 0.001. Our data show that SF-36 has validity and reliability and can be used in patients with endometriosis. Surgery improved the QoL and digestive function.
Highlights
Deep endometriosis (DE) is characterized by the presence of endometriosis lesions that infiltrate the peritoneum by >5 mm [1]. It occurs in approximately 1% of women of reproductive age and it affects between 4% and 37% of women with pelvic endometriosis [2]
Of the patients enrolled in CIRENDO, we selected for analysis those with histologically confirmed endometriosis and one-year follow-up visit
Among the patients included in the study, 29.1% reported a history of mental health disorders, 97.7% had dysmenorrhea and 76.2% had dyspareunia
Summary
Deep endometriosis (DE) is characterized by the presence of endometriosis lesions that infiltrate the peritoneum by >5 mm [1]. It occurs in approximately 1% of women of reproductive age and it affects between 4% and 37% of women with pelvic endometriosis [2]. The DE lesions typically affect the Douglas pouch, the uterosacral ligaments, the posterior vaginal wall, the anterior rectal wall, the sigmoid colon, the rectum and the urinary tract [3]. Additional gastrointestinal symptoms depend on the affected area and raise the clinical suspicion for infiltrative endometriosis lesions of the bowel. When the rectum and the sigmoid are affected, symptoms include deep dyspareunia, dyschezia, rectorrhagia, catamenial diarrhea and narrowed stools.
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