SF-36 preoperative interest of predicting improvement of quality of life after laparoscopic management of minimal endometriosis

Abstract

The purpose of the studyTo study preoperative thresholds of the SF-36 components above which we can predict a high risk of failure in order to improve the quality of life after surgery for patients with minimal endometriosis. Material and methodsDesign: prospective and multicenter observational study between February 2004 and 2011. Patients: 167 patients with operated minimal endometriosis. Setting: for the Physical Component Summary (PCS) or the Mental Component Summary (MCS) subscales of the SF-36 questionnaire, an improvement defined by an increase of 5 points. Intervention: evaluation by the SF-36 questionnaire the week before and one year after surgery. Measurement and main resultsSuccess of surgery measured by an improvement in both components. We found significantly different initial variables between patients with improvement and those without: initial MCS score (P=0.0003), initial PCS score (P<0.0001) and dyspareunia (P=0.004). Multivariate analysis revealed only two significant variables. Initial MCS higher than 40 (OR=4.6) and initial PCS higher than 50 (OR=10.6) are risk factors for failure of improvement after surgery. ConclusionSurgery is seldom a good treatment for improving QOL in minimal endometriosis. We set two thresholds for SF-36, 50 for PCS and 40 for MCS: above there is a very high risk of failure (86% of failure in our population). Under, the risk of failure remains high (54.3%). Canadian task force classification of study designEvidence obtained from well-designed cohort or case-control studies, preferably from more than one center or research group.