Short Form-36 Total Score Research Articles

Impact of interventions and tumor stage on health-related quality of life in patients with hepatocellular carcinoma.

This study aims to examine the health-related quality of life in patients with hepatocellular carcinoma. 181 patients attending a tertiary center outpatient clinic were interviewed and completed the short form 36 (SF36) questionnaire. The SF36 was used to assess health-related QoL. Cross-sectional analyses by group (age, gender, clinical scores, systemic, and local interventions) as well sequel questionnaires were conducted. Participants included were 79% (143/181) men [mean age at first SF36: 63.8 (± 12.3; 18.4-85.8)years]. Barcelona Clinic Liver Cancer (BCLC) stadium C was associated with significantly lower SF36 total scores, and elevated initial alpha-fetoprotein (AFP) concentrations were associated with lower SF36 functional and mental health sum scores throughout the course of the third questionnaire. Patients treated with sorafenib had within the sub-dimension scores a significantly lower result for role limitations due to physical health compared to patients without sorafenib treatment. Patients who underwent a transarterial chemoembolization (TACE) had within the sub-dimension scores a significantly higher result for control of pain compared to patients without TACE. Kaplan-Meier analysis revealed significant survival benefits for patients who underwent any intervention at the first SF36 (mean survival in years 4.3 vs. 1.6; P < 0.01) as well as for patients who underwent hepatic resection (mean survival in years 6.3 vs. 2.7; P < 0.0001). Advanced tumor stages marked by BCLC stadium C and elevated initial AFP concentrations were associated with lower SF36 total scores and functional sum scores, respectively. During the course of sorafenib treatment, the sub-dimensional score for role limitations due to physical health decreased significantly, whereas TACE performance was associated with a significant improvement of the control of body pain.

Impact of chronic disorders and obesity on quality of life in Northern Jordan

This study aimed to assess the health-related quality of life (QoL) among Jordanian adults with chronic disorders. A cross-sectional design using the convenience sampling technique was implemented and face-to–face interviews were carried out with 915 Jordanians who attended several shopping centers in Northern Jordan. The QoL was assessed using the Short Form 36 (SF-36) Health Survey. Data were obtained from 915 Jordanian adults from the general public with a mean age of 33.8 years (standard deviation, SD ± 28.2). Obesity was prevalent in 23.0% of the participants and approximately 35% suffered from musculoskeletal pain. The total SF-36 score for the whole population was 71.2. Physical health was dramatically affected by having different health problems, including rheumatoid arthritis, obesity, and back pain; (p < 0.05). Musculoskeletal pain, obesity, and asthma are considered to be major factors associated with decreased perception of general health and impairment in both the physical and mental domains of health-related QoL in Northern Jordan.

Trapezius Üst Kısmınında Miyofasyal Ağrı Sendromu Olan Diş Hekimlerinde Kinezyolojik Bantlama ile Egzersizin Etkinliğinin Sadece Egzersizin Etkinliği ile Karşılaştırılması

Objective: The aim in the present study was to compare the effectiveness of exercise plus kinesio taping versus exercise alone in dentists who have myofascial pain syndrome (MPS) of the upper trapezius muscle. Materials and Methods: In total, 47 dentists diagnosed with MPS of the upper trapezius muscle were included in the study. The patients were divided into two groups according to the dual block randomisation method. The patients in the first group (n = 23) received kinesio taping for the upper trapezius muscle and an exercise programme. The patients in the second group (n = 24) received only an exercise programme. All patients completed the study. The severity of the pain was measured with the visual analogue scale (VAS). An algometer was used to determine the pressure pain threshold, and the quality of life was measured using the Short Form-36 (SF-36) Health Survey. Results : The mean age of the patients included into the study was 29.83 ± 5.45 in the kinesio taping group and 31.79 ± 5.60 in the exercise alone group. In both groups, a significant improvement in pain values was observed between the evaluations performed at the beginning and at the end of the study (p < 0.05). After the treatment, it was observed that the kinesio taping group exhibited higher improvement (p < 0.05) in the pain scores at rest and during activity as measured by VAS, pressure pain threshold values and using the subscales (physical functioning, social role functioning, vitality [energy], emotional role limitation, physical role limitation, mental health and general health perceptions) and total SF-36 scores. Only the improvement in the ‘bodily pain’ subscale of the SF-36 did not show statistically significant difference between the groups (p > 0.05). Conclusion: The present study found that exercise therapy alone and exercise plus kinesio taping are beneficial in reducing pain in dentists with MPS of the upper trapezius muscle. The use of kinesio taping plus exercise provided further improvement in the resting and activity pain scores, pressure pain threshold and in certain subscales of the quality of life scale.

Quality of Life and Depression in Turkish Patients with β-Thalassemia Major: A Cross-Sectional Study

Thalassemias are the most common monogenic disorders worldwide. Thalassemia patients experience difficulties in their schooling, finding jobs and/or marriage because of functional and physical limitations caused by this disease. It is expected that the quality of life (QoL) of patients with thalassemia will be lower than those without this disease. The aim of this study was to benefit worldwide thalassemia patients in terms of QoL and mental health. This cross-sectional study was performed in Turkey. The study population consisted of of 57 β-thalassemia major (β-TM) patients and the control group. The short form-36 (SF-36) questionnaire and Beck depression inventory (BDI) were used. The mean age of the patients was 21.6 ± 6.6 (age range 15-39) and the male-to-female ratio was 0.7. The mean SF-36 scores of the patient and the control groups were 59.2 ± 12.4 and 75.7 ± 11.8, and the mean BDI scores of the patients and controls were 13.5 ± 6.4 and 6.1 ± 3.7, respectively. There was a statistically significant difference between the total SF-36 and BDI scores of patients and controls. We aimed to investigate the effects of the decrease in morbidity and mortality of β-thalassemia (β-thal) due to regular transfusions and chelation therapy on the QoL and mental health of patients. The β-TM patients have a comparatively worse QoL score than the normal population. Improving QoL should be the target of clinicians who are monitoring adolescent or young adult β-TM patients.

Long-term Quality of Life Following Vestibular Schwannoma Excision Via the Translabyrinthine Approach.

To assess postoperative quality of life (QOL) and other patient-reported outcomes following surgery for vestibular schwannoma. Cross-sectional retrospective case review using postal questionnaires. Tertiary referral center. Five hundred consecutive patients undergoing surgery for vestibular schwannoma. Patients undergoing surgery via the translabyrinthine approach (excluding neurofibromatosis type 2) under the senior author, with a minimum of 5 years follow-up, were included. QOL was assessed using the Short Form 36 (SF-36) questionnaire and a disease-specific survey to assess patients' subjective outcomes. The SF-36 scores in this group were significantly lower than the general UK population, though 24% of respondents reported a subjective improvement in overall QOL. Tumors larger than 4 cm were related to a reduced SF-36 total mental component score (p = 0.037). Increased age at time of surgery correlated with a reduced physical component of QOL (correlation coefficient = -0.26) and an improved mental component (correlation coefficient = 0.26). Subjective reports of postoperative symptoms and return to work, driving and social activities were similar to other published studies. 35% of patients reported vivid dreams or nightmares following surgery; the first reported incidence of this phenomenon in a large group of vestibular schwannoma patients. Generic measures of QOL in patients following translabyrinthine surgery for vestibular schwannoma do not always match subjective reports, reflecting the complexity of QOL assessment and the range of outcomes in this group. Increased time since surgery appears to be associated with an improvement in mental health.

Effect of Spinal Fusion Surgery on Total Hip Arthroplasty Outcomes: A Matched Comparison Study

BackgroundStudies regarding postoperative outcomes after primary total hip arthroplasty (THA) in patients who have comorbid factors tend to focus on medical diseases. However, there is a paucity of literature examining the effect of a patient's orthopedic surgical history on outcomes after THA. Significantly, there are currently no studies on the effect of spinal fusion surgery on THA outcomes. MethodsA review of 82 consecutive patients who had prior spinal fusion surgery who underwent elective THA from January 1, 2006 to December 31, 2015, was conducted. A matching cohort of 82 patients was selected from the remaining THA patients to maintain a 1:1 ratio control group. This cohort of 82 patients was matched for age, gender, body mass index ±5, preoperative Oxford score ±10, total Short Form-36 score ±10, and total Western Ontario and McMaster Universities Arthritis Index (WOMAC) score ±50. Data on the same functional outcomes were prospectively collected at 6-month and 2-year follow-up for comparison. ResultsPatients without spinal fusion had better outcome scores than patients with prior spinal fusion, specifically in their 6-month WOMAC scores (253.33-225.07; P = .046), their 2-year Short Form-36 total scores (79.71-69.21; P = .041), and their 2-year WOMAC scores (213.5-267.41; P = .054). ConclusionThis study demonstrates that patients with prior spinal fusion had worse outcomes after THA than patients without prior spinal fusion. This has clinical significance in counseling patients with previous spinal fusion undergoing THA.

Correlation of Physical Performance and Patient-Reported Outcomes Following Total Ankle Arthroplasty.

Functional recovery following total ankle arthroplasty (TAA) is assessed with patient-reported metrics, but physical performance tests may allow for a more accurate assessment of patient function. We quantified correlations between patient-reported measures and physical performance tests in patients after TAA to determine the usefulness of physical performance tests in post-TAA assessment. In total, 140 patients with end-stage ankle osteoarthritis were assessed prior to TAA and again at 12 and 24 months postoperatively. At each time point, the visual analog scale (VAS), Foot and Ankle Disability Index (FADI), American Orthopaedic Foot & Ankle Society (AOFAS), Short Musculoskeletal Function Assessment (SMFA), and Short-Form 36 (SF-36) scores were collected, as well as walking speed, Four-Square Step Test (FSST) times, and Short Physical Performance Battery (SPPB) balance scores. All but 1 (SF-36 general health component) of the patient-reported outcomes improved significantly from preoperative assessment to both 1 and 2 years postoperatively ( P < .001 in all cases). Walking speed, FSST times, and balance scores improved significantly across time ( P < .001 in all cases). Walking speed was moderately correlated with total SF-36 scores at both 1 and 2 years postoperatively ( P < .001 in both cases), both components of the SMFA at 1 year postoperatively ( P < .001 in both cases), and total AOFAS scores at 2 years postoperatively ( P = .001). The lack of strong correlations between the 2 sets of metrics indicates that they provide different information about a patient's recovery following TAA. Therefore, it is important to include both sets of metrics in post-TAA assessments to better understand operative success and functional recovery. Level IV, cohort study.

PP.30.22] DYSLIPIDEMIA AND AGGRAVATED QUALITY OF LIFE IN HYPERTENSIVES

Objective: Essential hypertension (EH) has a negative impact on health-related quality of life (H-rQoL) while dyslipidemia very often accompanies the hypertensive sequelae. We assesed the hypothesis that the combination of EH and dyslipidemia may have an additive effect on H-rQoL. Design and method: We studied 145 subjects with newly diagnosed stage I-II untreated EH (aged 56 ± 7 years, 47 = dyslipidemic, office blood pressure = 156/92 mmHg). Venous sampling was performed for estimation of lipidemic profile. The validated Greek version of Short Form 36 (SF-36) General Health Survey questionnaire was administered. The 8 subscales of SF-36 were further grouped into two summary scales: the physical component summary scale (PCS) and the mental component summary scale (MCS). Non-parametric Mann-Whitney and Spearmann rho tests were performed. Results: Dyslipidemic hypertensives demonstrated significantly lower scores in all SF-36 dimensions compared to non dyslipidemic (Table). There was a negative correlation between scores in general health and the total SF-36 score with serum triglycerides level (r = -0.284 p = 0.009, r = -0.287 p = 0.014, respectively).Conclusions: Dyslipidemia exerts an additive detrimental effect on quality of life in the setting of essential hypertension. Whether the above mentioned association contributes to the high cardiovascular risk observed in those patients remains to be determined in future studies.

Validation of the ECOS-16 Questionnaire in Koreans with Osteoporosis.

Study DesignProspective study.PurposeTo evaluate the reliability and validity of the adapted Korean version of the Quality of Life Questionnaire of the European Foundation for Osteoporosis (ECOS-16).Overview of LiteratureThe validity of the Korean version of ECOS-16 has not been completely demonstrated.MethodsTranslation/retranslation of the English version of ECOS-16, and full cross-cultural adaptation were performed. The Korean version of a visual analog scale measure of pain, and the Korean versions of ECOS-16 and of the previously validated short form-36 (SF-36) were mailed to 158 consecutive patients with osteoporosis. Factor analysis and reliability assessment using kappa statistics of agreement for each item, intraclass correlation coefficient, and Cronbach's α were done. Construct validity was evaluated by comparing responses to ECOS-16 with responses to SF-36 using Pearson's correlation coefficient.ResultsFactor analysis extracted three factors. All items had a kappa statistics of agreement >0.6. The ECOS-16 showed good test/re-test reliability (0.8469) and internal consistency of Cronbach's α (0.897). The Korean version of ECOS-16 showed significant correlation with SF-36 total scores and with single SF-36 domains scores.ConclusionsThe adapted Korean version of the ECOS-16 was successfully translated and showed acceptable measurement properties. It is considered suitable for outcome assessments in Korean patients with osteoporosis.

PP.30.22

Objective: Essential hypertension (EH) has a negative impact on health-related quality of life (H-rQoL) while dyslipidemia very often accompanies the hypertensive sequelae. We assesed the hypothesis that the combination of EH and dyslipidemia may have an additive effect on H-rQoL. Design and method: We studied 145 subjects with newly diagnosed stage I-II untreated EH (aged 56 ± 7 years, 47 = dyslipidemic, office blood pressure = 156/92 mmHg). Venous sampling was performed for estimation of lipidemic profile. The validated Greek version of Short Form 36 (SF-36) General Health Survey questionnaire was administered. The 8 subscales of SF-36 were further grouped into two summary scales: the physical component summary scale (PCS) and the mental component summary scale (MCS). Non-parametric Mann-Whitney and Spearmann rho tests were performed. Results: Dyslipidemic hypertensives demonstrated significantly lower scores in all SF-36 dimensions compared to non dyslipidemic (Table). There was a negative correlation between scores in general health and the total SF-36 score with serum triglycerides level (r = -0.284 p = 0.009, r = -0.287 p = 0.014, respectively).Conclusions: Dyslipidemia exerts an additive detrimental effect on quality of life in the setting of essential hypertension. Whether the above mentioned association contributes to the high cardiovascular risk observed in those patients remains to be determined in future studies.

A Study on Assessment of Health Related Quality of Life in COPD and Asthma Patients in a Tertiary Care Teaching Hospital

Aim: The aim of this study was to evaluate the association between health-related quality of life (HRQL) and disease severity using both disease specific and generic specific questionnaires and lung function measures. Methods: A survey was performed in patients with COPD and Asthma in tertiary care teaching hospital. One hundred and twenty (120) subjects (92 men and 28 women, mean age 48.6 years) completed the generic HRQL questionnaire; the Short Form 36 (SF-36) and disease-specific HRQL questionnaire; the St George's Respiratory Questionnaire (SGRQ). The subjects were divided into four severity groups according to FEV 1 percent of predicted normal using two clinical guidelines: GOLD and BTS. Results: From our study it was observed that the mean scores of SF-36 PCS is 40.46, p<0.0001 and MCS is 40.22, p<0.0001which showed an average HRQL and was significantly associated with COPD and Asthma. The COPD severity grades affected the SGRQ Total scores, varying from 67.8 to 22.9 (GOLD p<0.0001) and from 64.1 to 22.9 (BTS p<0.0001). The four stages of FVC% predicted had an impact on HRQL similar to the stages of FEV 1 % predicted outlined from GOLD and BTS. Strong negative correlation (-0.645, p<0.0001) was observed between SF-36 and SGRQ total scores, strong negative correlation (-0.847, p<0.0001) between SGRQ total scores and FEV 1 %/FVC% predicted in contrast with positive correlation (0.583, p<0.0001) with SF-36 and FEV 1 %/FVC% predicted. Conclusion: The results showed that HRQL in COPD deteriorates with disease severity and age. The results also showed that the level of HRQL of COPD and Asthma subjects deteriorate considerably with increase in the severity of disease and such deterioration showed linear relation to the decrease in the FEV 1 % predicted normal values.

Effect of postoperative physical training on activity after curative surgery for non-small cell lung cancer: a multicentre randomised controlled trial

ObjectiveTo evaluate the effect of a combined hospital plus home exercise programme following curative surgery for non-small cell lung cancer (NSCLC). DesignRandomised controlled trial. SettingTeaching hospital. ParticipantsOne hundred and thirty-one subjects with NSCLC admitted for curative surgery. InterventionsParticipants were randomised to usual care or a hospital plus home exercise programme. OutcomesThe primary outcome was the between-group difference in physical activity 4 weeks after surgery. Secondary outcomes were the difference in quadriceps strength, exercise tolerance and quality of life [Short Form-36 (SF-36) and European Organisation for Research and Treatment of Cancer (EORTC) QLQ-LC13] from pre-operatively (baseline) to 4 weeks after surgery. ResultsThe participants (n=131) had a mean age of 68 [standard deviation (SD) 11] years and mean forced expiratory volume in 1second of 2.4 (SD 1.1)l. There were no significant differences in physical activity between the groups 4 weeks after surgery [mean difference adjusted for baseline 12minutes/day, 95% confidence interval (CI) −20.2 to 44.1]. In addition, there were no significant differences in total SF-36 or EORTC QLQ-LC13 scores from baseline to 4 weeks after surgery. Both groups had recovered their pre-operative walking distance 4 weeks after surgery, and there were no differences between the groups (mean difference in Incremental Shuttle Walk Test from baseline to 4 weeks after surgery (−26m, 95% CI −94.2 to 42.3). ConclusionsA hospital plus home exercise programme showed little benefit in unselected patients with NSCLC following surgery. Regardless of group allocation, the patients had recovered their pre-operative exercise tolerance levels by 4 weeks after surgery.

Surgical Correction of Severe Deformity of the Ankle and Hindfoot by Arthrodesis Using a Compressing Retrograde Intramedullary Nail

Tibiotalocalcaneal arthrodesis with a retrograde intramedullary nail is a widely used surgical technique for the treatment of concomitant tibiotalar and subtalar arthritis and correction of accompanying deformity. This study was undertaken to evaluate the union rate, deformity correction, and clinical outcomes achieved using a compressing retrograde intramedullary nail. Thirty tibiotalocalcaneal arthrodeses with an osseous compressing arthrodesis nail system were studied with a mean follow-up of 26 months. Radiographic data were collected on deformity correction and union rate, and clinical outcomes were evaluated using the Visual Analogue Scale (VAS) for pain, the American Orthopaedic Foot & Ankle Society (AOFAS) Ankle/Hindfoot Score, and the Short Form-36 (SF-36) health survey. Records were reviewed for complications and concomitant procedures. Thirteen of 30 operated limbs had a preoperative coronal plane deformity exceeding 15 degrees. Mean magnitude of correction was 13.2 degrees (range, 0-32 degrees, standard deviation ±9.6). In total, 76% of limbs (23/30) had postoperative coronal deformity of less than 5 degrees. Union was achieved in 96.6% of patients. There were 3 cases of tibial stress reaction, 3 cases of transient plantar nerve irritation, and 3 cases of wound infection. Clinical outcomes demonstrated a reduction in mean VAS score from 6.5 to 1.3 (P < .01), an increase in mean AOFAS Ankle/Hindfoot Scores from 29.7 to 74.3 (P < .01), and an increase in mean total SF-36 scores from 85.6 to 98.8 (P < .01). A compressing retrograde intramedullary nail was effective in achieving deformity correction, a high union rate, and improvement in clinical outcomes. Level IV, retrospective case series.

Validation of the Quality-of-Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO-26) in Korean population

We aimed to evaluate the reliability and validity of the adapted Korean version of the Quality-of-Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO-26). Translation/retranslation of the English version of QUALEFFO was conducted, and all steps of the cross-cultural adaptation process were performed. The Korean version of the visual analog scale measure of pain, QUALEFFO-26 and the previously validated Short Form-36 (SF-36) were mailed to 162 consecutive patients with osteoporosis. Factor analysis and reliability assessment by kappa statistics of agreement for each item, the intraclass correlation coefficient and Cronbach's α were conducted. Construct validity was also evaluated by comparing the responses of QUALEFFO-26 with the responses of SF-36 using Pearson's correlation coefficient. Factor analysis extracted 3 factors. All items had a kappa statistics of agreement greater than 0.6. The QUALEFFO-26 showed good test/retest reliability (QUALEFFO-26: 0.8271). Internal consistency of Cronbach's α was found to be very good (QUALEFFO-26: 0.873). The Korean version of QUALEFFO-26 showed good significant correlation with SF-36 total score and with single SF-36 domains scores. The adapted Korean version of the QUALEFFO-26 was successfully translated and showed acceptable measurement properties and, as such, is considered suitable for outcome assessments in the Korean-speaking patients with osteoporosis.

AB1318 Quality of sleep (QOS), quality of life (QOL) and depression in patients with rheumatoid arthritis: The relationship between disease activity and using TNF-alpha blocker

BackgroundPatients with rheumatoid arthritis (RA) suffer from not only pain but also sleep disturbance and depression. However, in the previous study, there was less data about quality of sleep (QOS),...

SAT0451 Quality of sleep (QOS) and quality of life (QOL) in patients with osteoarthritis and rheumatoid arthritis

BackgroundPatients with musculoskeletal disorders, such as osteoarthritis (OA) and rheumatoid arthritis (RA) suffer from not only pain but also insomnia, day time sleepiness, and other sleep disturbances. Poor sleep may...

AB1312 Higher habitual physical activity levels are protective of functional capacity and quality of life in female patients with rheumatoid arthritis regardless of disease activity

BackgroundRheumatoid Arthritis (RA) is a chronic pain condition which limits the ability of patients to function normally and therefore decreases their physical activity levels [1]. Physical activity is difficult to...

Validation of the Korean Version of the Neck Pain and Disability Scale

Study DesignA prospective study.PurposeTo evaluate the reliability and validity of the adapted Korean version of the Neck Pain and Disability Scale (NPDS).Overview of LiteratureThe validity of Korean version of NPDS has not been completely demonstrated yet.MethodsTranslation/retranslation of the English version of NPDS was conducted, and all steps of the cross-cultural adaptation process were performed. The Korean version of the visual analog scale (VAS) measure of pain, NPDS and the previously validated Short Form-36 (SF-36) were mailed to 91 patients, who had been surgically treated for degenerative cervical disease. Eighty-one patients responded to the first mailing of questionnaires and 69 of the first time responder returned their second survey. Factor analysis and reliability assessment by kappa statistics of agreement for each item, the intraclass correlation coefficient and Cronbach's α were conducted. Concurrent and construct validity were also evaluated by comparing the responses of NPDS with the results of VAS and responses of SF-36.ResultsFactor analysis extracted 3 factors. All items had a kappa statistics of agreement greater than 0.6. The NPDS showed excellent test/re-test reliability. Internal consistency of Cronbach's α was found to be very good. The NPDS was correlated with the VAS. The Korean version of NPDS showed good significant correlation with SF-36 total score and with single SF-36 domains scores.ConclusionsThe adapted Korean version of the NPDS was successfully translated and is considered suitable for outcome assessments in the Korean-speaking patients with neck pain.

Airway Hyperresponsiveness and Quality of Life in Western Red Cedar Asthmatics Removed from Exposure

ObjectivesMost western red cedar asthmatics (WRCA) continue to have symptoms even after removal from exposure. Consequently, health-related quality of life (HRQL) is often impaired. The objective of this study was to evaluate the relationship between two measures of AHR and HRQL scores in those with WRCA.MethodsHRQL was determined by the short form 36 (SF-36) in 46 male, non-smoking individuals with WRCA removed from exposure to western red cedar, on average, 15 years earlier. The relationships between the SF-36 total score and its eight domains with 2 indices from methacholine-stimulated airway hyperresponsiveness (the provocative concentration of methacholine causing a 20% fall in FEV1 [PC20] and bronchial reactivity index [BRI]) were analyzed by the Pearson correlation and multiple linear regression.ResultsPC20 was significantly correlated with the SF-36 total score and its two domains of bodily pain and general health (r = 0.34, 0.40, 0.40, p = 0.023, 0.006, 0.006, respectively). BRI was significantly correlated with bodily pain and general health (r = −0.35, −0.42, p = 0.017, 0.004, respectively); correlations remain significant after adjusting for age, ethnicity, years since diagnosis, years since last exposure and use of inhaled corticosteroid. BRI and other measures of airway responsiveness were not associated with inhaled corticosteroids use.ConclusionsIn Western red cedar asthmatics removed from exposure, measures of airway responsiveness are associated with HRQL.

Combined Oral Contraceptive Therapy in Women with Posterior Deep Infiltrating Endometriosis

Study Objective To estimate the effect of combined oral contraceptives (COCs) in women with deep infiltrating endometriosis. Design Retrospective study (Canadian Task Force classification II-2). Setting Tertiary care university hospital. Patients One hundred six women with uncomplicated posterior deep infiltrating endometriosis scheduled to undergo laparoscopic surgery between November 2004 and November 2009. Interventions During the waiting-list time, between surgical scheduling and laparoscopic intervention (preoperative period), 75 patients received cyclic COCs (users), and 31 received no hormone therapy (COC nonusers). Measurements and Main Results Patients had undergone 2 clinical examinations, at surgical scheduling and immediately before surgery. Presence and intensity of dysmenorrhea, dyspareunia, chronic pelvic pain, and dyschezia were evaluated using a 10-point visual analog scale (VAS) (primary outcome). In both examinations, patients underwent transvaginal ultrasonography to evaluate localization and mean diameter of endometriotic nodules. Quality of life was evaluated using the Short Form-36 (SF-36) score. Mean (SD) nodule diameter at the beginning and end of the preoperative period in COC users was, respectively, 24.81 (15.13) mm and 26.66 (15.5) mm (p = .09), and in the nonuser group was, respectively, 23.09 (11.11) mm and 30.89 (19.1) mm (p = .007). In COC users, VAS scores for dysmenorrhea, dyspareunia, chronic pelvic pain, and dyschezia did not vary significantly during the preoperative period (p = .90, p = .55, p = .15, and p = .17, respectively). In nonusers, VAS scores for dysmenorrhea and dyspareunia were significantly higher at the second examination than at the first examination (p = .002 and p = .005, respectively), whereas scores for chronic pelvic pain and dyschezia did not vary during the preoperative period (p = .88 and p = .16, respectively). The Short Form-36 total score did not vary significantly during the preoperative period in either the COC user group (p = .82) or the nonusers group (p = .76). Conclusions Combined oral contraceptive therapy can have a role in restraining the progression of dysmenorrhea and dyspareunia and the growth of deep endometriotic nodules.