The repercussions of the laparoscopic surgical treatment of women with deep endometriosis in the quality of life, in depression and sexual function

In: instacron:UFC · 2019 · W7120417979
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Laparoscopic surgery for deep endometriosis improved overall quality of life, reduced depression, and enhanced sexual function and pain, except for specific aspects of mental health and sexual response.

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This prospective hospital-based cohort study evaluated 66 women undergoing laparoscopic surgery with fertility preservation for deep endometriosis, assessing general quality of life (SF-36), depression (Beck Depression Inventory), multidimensional pain (McGill scale), and sexual function (FSFI) before surgery and again at 6 months for 35 responders. Compared with preoperative assessments, participants showed improvements across SF-36 domains except emotional aspect and mental health, along with better depression scores, higher overall FSFI scores, and lower pain on most McGill dimensions. However, lubrication, orgasm, and satisfaction did not significantly improve, and McGill’s evaluative cognitive aspect did not change, with no significant associations found between sexual function and most quality-of-life, depression, or pain measures. The paper directly addresses deep endometriosis—specifically, the repercussions of laparoscopic surgery (with fertility preservation) on quality of life, depression, and sexual function—making it centrally about endometriosis.

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Abstract

Endometriosis is defined by the presence and growth of endometrial tissue outside the uterine cavity, whos e prevalence is 10 to 15% of women in the reproductive phase. Symptoms of endometriosis can often affect the psychological and social functioning of patients, so it is considered a disabling condition that can significantly compromise quality of life, soci al relationships, sexuality and mental health. The main objective of this article is to evaluate the impact of laparoscopic surgery with preservation of fertility for the treatment of deep endometriosis in the general quality of life, depression, sexual fu nction and multidimensional pain scale, as well as to try to establish correlations between these items that impact greatly the well being of women with endometriosis. METHODS: A prospective, hospital based cohort study that evaluated 66 women who underwen t surgical treatment for deep endometriosis at Assis Chateaubriand Maternity School from March 2016 to July 2018. The general quality of life questionnaire (SF 36); the Beck Depression Inventory (IDB), the Sexual Function Questionnaire (FSFI), and the McG ill Multidimensional Pain Scale. After 6 months of surgery, in the outpatient return, 35 patients answered again the questionnaires and the scale mentioned above. Results: when compared before and after surgery, the patients had improvement in the areas of SF36, except Emotional Aspect and Mental Health. They also improved IDB and overall FSFI scores, in addition to the McGill Multidimensional Pain Scale, but there was no significant improvement in lubrication, orgasm and satisfaction, nor in McGill's evalu ative cognitive aspect. There was a negative correlation both before and after the IDB surgery with all SF36 domains. The same was not shown for sexual function, which did not have a significant correlation with either the majority of the SF 36 domains or the BDI and the McGill scale. There was an improvement in the FSFI overall score, but there was no increase in the cut off point 26 considered in the literature as a lower chance of sexual dysfunction. Conclusion: It is concluded that laparoscopic surgery for the treatment of deep endometriosis improves overall quality of life in all SF 36 domains, except for Mental Health and Emotional Aspect, which decreases the risk of depression, which improves the FSFI total score and in the areas of Desire, Excitement and Pain and that diminishes pain in almost all aspects.
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Please use this identifier to cite or link to this item: http://repositorio.ufc.br/handle/riufc/42718 | Type: | Tese | | Title: | As repercussõesdo tratamento cirúrgico laparoscópico das mulheres com endometriose profunda na qualidade de vida, na depressão e na função sexual | | Title in English: | The repercussions of the laparoscopic surgical treatment of women with deep endometriosis in the quality of life, in depression and sexual function | | Authors: | Augusto, Kathiane Lustosa | | Advisor: | Bezerra, Leonardo Robson Pinheiro Sobreira | | Keywords: | Endometriose;Qualidade de Vida;Depressão;Disfunção Erétil | | Issue Date: | 30-Apr-2019 | | Citation: | AUGUSTO, K. L. As repercussões do tratamento cirúrgico laparoscópico das mulheres com endometriose profunda na qualidade de vida, na depressão e na função sexual. 2019. 76 f Tese (Doutorado em Ciências Médico-Cirúrgicas) Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, 2019. | | Abstract in Brazilian Portuguese: | Endometriose é definida pela presença e crescimento de tecido endometrial fora da cavidade uterina , cuja prevalência é de 10 a 15% das mulheres na fase reprodutiva . Os sintomas da endometriose freq u entemente podem afetar o funcionamento psicol ó gico e social das pacientes, portanto é considerada uma condição incapacitante que pode comprometer significativamente a qualidade de vida, as relações sociais, a sexualidade e a saú de mental . O objetivo principal desse artigo é avaliar o impacto da cirurgia laparoscópica com preservação da fertilidade para o tratamento da endometriose profunda na qualidade de vida geral, depressão, função sexual e escala multidimensional de dor, além de tentar estabelecer correlações entre esses quesitos que impactam de sobremaneira o bem estar das mulheres com endometriose. Método: estudo coorte prospectivo de base hospitalar que avaliou 66 mulheres que se submeteram a tratamento cirúrgico para endom etriose profunda na Maternidade Escola Assis Chateaubriand no período de março de 2016 a julho de 2018. F oram aplicados o questionário de qualidade de vida geral (SF 36); o I nventário de depressão de Beck (IDB), Questionário de função sexual (FSFI ) e a Esc ala Multidimensional de dor McGill . Após 6 meses da cirurgia, no retorno ambulatorial, 35 pacientes responderam novamente os questionários e a escala acima citados. Resultados: quando comparou se antes e após a cirurgia, as pacientes tiveram melhora nos do mínios do SF36, exceto Aspecto emocional e Saúde Mental. Melhoraram também a pontuação do IDB e do FSFI geral, além da Escala Multidimensional da dor McGill, porém não houve melhora significativa na l ubrificação, orgasmo e satisfação, e nem no quesito aval iativo cognitivo do McGill. Houve correlação negativa tanto antes quanto após a cirurgia do IDB com todos os domínios do SF36. O mesmo não se mostrou quanto a função sexual, que não teve uma correlação significativa nem com a maioria dos domínios do SF 36 nem do IDB e da escala de McGill. Houve uma melhora da pontuação geral do FSFI, porém não houve um aumento para o ponto de corte 26 considerado na literatura como menor chance de disfunção sexual . Conclui se que a cirurgia laparoscópica para tra tamento de endometriose profunda melhora qualidade de vida geral em todos os domínios do SF 36, exceto Saúde mental e Aspecto Emocional, que diminui o risco de depressão, que melhora a pontuação total do FSFI e nos domínios Desejo, Excitação e Dor e que di minui dor em todos os aspectos exceto no Avaliativo. | | Abstract: | Endometriosis is defined by the presence and growth of endometrial tissue outside the uterine cavity, whos e prevalence is 10 to 15% of women in the reproductive phase. Symptoms of endometriosis can often affect the psychological and social functioning of patients, so it is considered a disabling condition that can significantly compromise quality of life, soci al relationships, sexuality and mental health. The main objective of this article is to evaluate the impact of laparoscopic surgery with preservation of fertility for the treatment of deep endometriosis in the general quality of life, depression, sexual fu nction and multidimensional pain scale, as well as to try to establish correlations between these items that impact greatly the well being of women with endometriosis. METHODS: A prospective, hospital based cohort study that evaluated 66 women who underwen t surgical treatment for deep endometriosis at Assis Chateaubriand Maternity School from March 2016 to July 2018. The general quality of life questionnaire (SF 36); the Beck Depression Inventory (IDB), the Sexual Function Questionnaire (FSFI), and the McG ill Multidimensional Pain Scale. After 6 months of surgery, in the outpatient return, 35 patients answered again the questionnaires and the scale mentioned above. Results: when compared before and after surgery, the patients had improvement in the areas of SF36, except Emotional Aspect and Mental Health. They also improved IDB and overall FSFI scores, in addition to the McGill Multidimensional Pain Scale, but there was no significant improvement in lubrication, orgasm and satisfaction, nor in McGill's evalu ative cognitive aspect. There was a negative correlation both before and after the IDB surgery with all SF36 domains. The same was not shown for sexual function, which did not have a significant correlation with either the majority of the SF 36 domains or the BDI and the McGill scale. There was an improvement in the FSFI overall score, but there was no increase in the cut off point 26 considered in the literature as a lower chance of sexual dysfunction. Conclusion: It is concluded that laparoscopic surgery for the treatment of deep endometriosis improves overall quality of life in all SF 36 domains, except for Mental Health and Emotional Aspect, which decreases the risk of depression, which improves the FSFI total score and in the areas of Desire, Excitement and Pain and that diminishes pain in almost all aspects. | | URI: | http://www.repositorio.ufc.br/handle/riufc/42718 | | Appears in Collections: | DCIR - Teses defendidas na UFC | Files in This Item: | File | Description | Size | Format | | |---|---|---|---|---| | 2019_tese_klaugusto.pdf | 3,48 MB | Adobe PDF | View/Open | Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

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