Laparoscopic nerve-sparing complete excision of deep endometriosis: is it feasible?

Stefano Landi, S Landi, Marcello Ceccaroni, M. Ceccaroni, A Perutelli, Perutelli A, Allodi C, C. Allodi, F Barbieri, Barbieri F, A. Fiaccavento, Andrea Fiaccavento, Fiaccavento A, G. Ruffo, Ruffo G, Giacomo Ruffo, E McVeigh, McVeigh E, Enda McVeigh, L Zanolla, Luisa Zanolla, Minelli L, Liliana Minelli, L. Minelli
Human Reproduction · 2006 · vol. 21(3) , pp. 774–781 · doi:10.1093/humrep/dei324 · PMID:16449312 · W2102284561
Non-randomised trial OA: bronze CC0 ⤵ 124 in-corpus citations
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A prospective study found laparoscopic nerve-sparing complete excision of deep endometriosis was feasible and reduced bladder morbidity and increased patient satisfaction compared to a non-nerve-sparing technique.

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Abstract

BACKGROUND: Little is known about the morbidity associated with laparoscopic complete excision of endometriosis in terms of urinary, digestive and sexual function. METHODS: We performed a prospective non-randomized study in 45 patients with laparoscopic complete excision of all detectable foci of endometriosis with segmental bowel resection using a non nerve-sparing technique (control group-group A n=20) and a nerve-sparing technique (case group-group B n=25). At initial gynaecological evaluation, and at follow-up details on dysmenorrhoea, pelvic pain, dyspareunia and dyschezia were evaluated using an interview-based questionnaire (10-point analogue rating scale: 0=absent, 10=unbearable). RESULTS: The mean (+/-SD) follow-up period was 15.3+/-10 months (range, 8.8-23 months) for group A and 3.5+/-2.1 months (range, 0.3-5.2 months) for group B. In the immediate postoperative course, in group A three women required blood transfusion vs seven women in group B (P=0.003). The median time to resume the voiding function was significantly shorter in group B (12.5 vs 3.0 days; P<0.01). At the time of follow-up a higher proportion of patients in group B were 'very satisfied' than those in group A (87.7% vs 59.0%, P=0.013). CONCLUSIONS: Laparoscopic nerve-sparing complete excision of endometriosis seems to be feasible and offers good results in terms of bladder morbidity reduction with apparently higher satisfaction than classical technique. Larger series with longer follow-up are needed to confirm our results.

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Condition tags

endometriosisdysmenorrheadyspareunia

MeSH descriptors

Endometriosis Endometrium Laparoscopy Adult Adult Endometriosis Endometriosis Endometriosis Endometrium Endometrium Endometrium Feasibility Studies Feasibility Studies Female Female Humans Humans Laparoscopy Laparoscopy Postoperative Pain

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (34)

Cited by (50)

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