Is nerve-sparing surgery suitable for deeply infiltrating endometriosis?

Che X, Xuan Che, Xiufeng Huang, Jing Zhang, Zhang J, Hong Xu, Xu H, Xinmei Zhang, Zhang X
European journal of obstetrics, gynecology, and reproductive biology · 2014 · vol. 175 , pp. 87–91 · doi:10.1016/j.ejogrb.2014.01.027 · PMID:24576484 · W2092673123
article OA: closed CC0 ⤵ 16 in-corpus citations
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This review assesses the suitability and outcomes of nerve-sparing surgery for treating deeply infiltrating endometriosis.

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Abstract

ObjectiveTo investigate the efficacy of nerve-sparing surgery for deeply infiltrating endometriosis (DIE) and the bladder and sexual dysfunction that follow this procedure.Study designA total of 108 women with DIE underwent conventional surgery (group A, n=63) and nerve-sparing surgery (group B, n=45). Three validated interview-based questionnaires - the visual analogue scale (VAS), the international prostate score symptom (IPSS), and the female sexual function index (FSFI) - were used to evaluate the efficacy and associated complications.ResultsThe VAS scores significantly decreased in both groups A and B after surgery, although two patients (4.4%) in group B had no improvement in their pain symptoms. The total FSFI and each domain scores significantly increased in the two groups after surgery except for satisfaction at the 24-month follow up in group A. Nine patients (15.9%) in group A required self-catheterization postoperatively. Based on the IPSS scores, a significant alteration in voiding symptoms in group A was observed at 6 months but not at 12 months or 24 months after surgery. In group B, however, no significant difference or self-catheterization requirement was observed after surgery.ConclusionsReduced bladder and sexual dysfunction, but with a risk of absence of pain relief, suggests that the pros and cons of nerve-sparing surgery for DIE should carefully be evaluated before operation.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Gynecologic Surgical Procedures Peripheral Nerve Injuries Sexual Dysfunction, Physiological Urination Disorders Adult Endometriosis Female Follow-Up Studies Gynecologic Surgical Procedures Humans Middle Aged Peripheral Nerve Injuries Sexual Dysfunction, Physiological Urination Disorders

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