Is nerve-sparing surgery suitable for deeply infiltrating endometriosis?
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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
OBJECTIVE: To investigate the efficacy of nerve-sparing surgery for deeply infiltrating endometriosis (DIE) and the bladder and sexual dysfunction that follow this procedure.
STUDY DESIGN: A 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.
RESULTS: The 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.
CONCLUSIONS: Reduced 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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Cited by (16)
- Functional and Surgical Outcomes of Nerve-Sparing Approaches in Deep Infiltrating Endometriosis: A Systematic Review and Meta-Analysis 2026
- Laparoendoscopic single-site surgery for deep infiltrating endometriosis based on retroperitoneal pelvic spaces anatomy: a retrospective study 2023
- Sexual self-efficacy and sexual quality of life before and after laparoscopic surgery in women with endometriosis lesions: A cross-sectional study 2022
- Urinary Retention After Laparoscopic Definitive Surgery for Stages III and IV Endometriosis Without Explicit Nerve-Sparing Techniques: A Retrospective Analysis 2022
- Impact of nerve-sparing posterolateral parametrial excision for deep infiltrating endometriosis on postoperative bowel, urinary, and sexual function 2022
- [Anatomic reports of vegetative nerves within para rectal fossa, to the rectal endometriosis surgery application] 2020
- Predictive approach in managing voiding dysfunction after surgery for deep endometriosis: a personalized nomogram 2020
- A systematic review on the effects of endometriosis on sexuality and couple's relationship 2020
- Functional outcomes of nerve-sparing laparoscopic eradication of deep infiltrating endometriosis: a prospective analysis using validated questionnaires 2018
- [Nerve sparing techniques in deep endometriosis surgery to prevent urinary or digestive functional disorders: Techniques and results: CNGOF-HAS Endometriosis Guidelines] 2018
- What Is Known and Unknown About the Association Between Endometriosis and Sexual Functioning: A Systematic Review of the Literature 2017
- When love hurts. A systematic review on the effects of surgical and pharmacological treatments for endometriosis on female sexual functioning 2016
- Sexual function in endometriosis patients and their partners: effect of the disease and consequences of treatment 2016
- Risk of urinary retention after nerve-sparing surgery for deep infiltrating endometriosis: A systematic review and meta-analysis 2015
- Role and Technique of Nerve-Sparing Surgery in Deep Endometriosis 2015
- Laparoscopic anatomy of the autonomic nerves of the pelvis and the concept of nerve-sparing surgery by direct visualization of autonomic nerve bundles 2015
Source provenance
- europepmc
- last seen: 2026-11-13T07:00:47.251693+00:00
- openalex
- last seen: 2026-06-10T17:14:06.276822+00:00
- pubmed
- last seen: 2026-10-08T21:13:21.326790+00:00
- unpaywall
- last seen: 2026-11-13T07:27:04.437940+00:00
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