Quality of life as a criterion for assessing the effectiveness of rehabilitation programs in patients with painful external genital endometriosis

In: Obstetrics, Gynecology and Reproduction · 2023 · vol. 17(1) , pp. 92–103 · doi:10.17749/2313-7347/ob.gyn.rep.2023.391 · W4323359821
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Active rehabilitation tactics significantly improved quality of life, reduced pain, and normalized sexual function in women with painful external genital endometriosis compared to passive tactics.

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This study evaluated quality of life outcomes after radical treatment in 104 reproductive-age women with painful external genital endometriosis, comparing “active” versus “passive” rehabilitation tactics in a framework of national clinical guidelines. QoL was assessed using subjective questionnaires (VAS, PainDETECT, EHP-30, HADS, and FSFI) at baseline and multiple follow-ups from 5–9 days through 12 months after surgery. Women receiving active, personalized multidisciplinary rehabilitation showed reductions in pain (including a neuropathic component), anxiety-depressive disorders, and improvements in sexual function and overall QoL compared with the passive group, where more severe disease course and lower QoL were reported. The paper does not explicitly describe other methodological limitations in the abstract, and its findings are based on the two rehabilitation strategies as implemented in this study. This paper is centrally about endometriosis — specifically, it assesses how rehabilitation programs affect quality of life in patients with painful external genital endometriosis.

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Abstract

Introduction. Chronic pelvic pain negatively affects the quality of life (QoL) of patients with a painful form of external genital endometriosis (EGE) and adversely impacts on the physical, psychoemotional and sexual health of reproductive-age women resulting in distress, maladaptation, anxiety-depressive disorders, disrupted social functioning in family relationships. Aim: to assess the QoL of women with painful EGE after radical treatment in the rehabilitation period by using subjective research methods. Materials and Methods. We examined 104 female patients of reproductive age (42.4 ± 3.7 years) with painful EGE after radical treatment: group IA – 49 women underwent "active" rehabilitation, group IB – 55 patients underwent "passive" rehabilitation tactics in accordance with standards and National Clinical Guidelines. The assessment of QoL (subjective) was performed using specialized questionnaires: visual analog scale (VAS), PainDETECT questionnaire, Endometriosis Health Profile-30 (EHP-30) questionnaire, Hospital Anxiety and Depression Scale (HADS), Female Sexual Function Index (FSFI). Assessment of QoL parameters was carried out at 6 control time points: before, as well as 5–9 days, 1, 3, 6 and 12 months after surgical treatment. Results. Patients underwent "active" rehabilitation tactics (group IA) showed prominently reduced pain syndrome, neuropathic component of pain, anxiety-depressive disorders, normalized sexual function and improved all QoL parameters, unlike patients managed with "passive" tactics, who underwent a complex of rehabilitation measures within the framework of National Clinical Guidelines (group IB). More severe EGE course and significantly decreased QoL in patients with painful EGE at "passive" rehabilitation tactics were noted. Conclusion. Applying a complex personalized rehabilitation program along with multidisciplinary approach in patients with painful EGE after radical treatment can markedly improve overall well-being, timely correct psychoemotional and sexual dysfunction, and therefore prominently increase the patients' QoL.
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Abstract

Introduction. Chronic pelvic pain negatively affects the quality of life (QoL) of patients with a painful form of external genital endometriosis (EGE) and adversely impacts on the physical, psychoemotional and sexual health of reproductive-age women resulting in distress, maladaptation, anxiety-depressive disorders, disrupted social functioning in family relationships. Aim: to assess the QoL of women with painful EGE after radical treatment in the rehabilitation period by using subjective research methods.

Materials

and Methods. We examined 104 female patients of reproductive age (42.4 ± 3.7 years) with painful EGE after radical treatment: group IA – 49 women underwent "active" rehabilitation, group IB – 55 patients underwent "passive" rehabilitation tactics in accordance with standards and National Clinical Guidelines. The assessment of QoL (subjective) was performed using specialized questionnaires: visual analog scale (VAS), PainDETECT questionnaire, Endometriosis Health Profile-30 (EHP-30) questionnaire, Hospital Anxiety and Depression Scale (HADS), Female Sexual Function Index (FSFI). Assessment of QoL parameters was carried out at 6 control time points: before, as well as 5–9 days, 1, 3, 6 and 12 months after surgical treatment. Results. Patients underwent "active" rehabilitation tactics (group IA) showed prominently reduced pain syndrome, neuropathic component of pain, anxiety-depressive disorders, normalized sexual function and improved all QoL parameters, unlike patients managed with "passive" tactics, who underwent a complex of rehabilitation measures within the framework of National Clinical Guidelines (group IB). More severe EGE course and significantly decreased QoL in patients with painful EGE at "passive" rehabilitation tactics were noted. Conclusion. Applying a complex personalized rehabilitation program along with multidisciplinary approach in patients with painful EGE after radical treatment can markedly improve overall well-being, timely correct psychoemotional and sexual dysfunction, and therefore prominently increase the patients' QoL. About the Authors E. BegovichRussian Federation Evana Begovich – MD, Postgraduate Student, Department of Obstetrics, Gynecology and Perinatal Medicine 2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991 B. Baigalmaa Russian Federation Baldansambuu Baigalmaa – MD, Postgraduate Student, Department of Obstetrics, Gynecology and Perinatal Medicine; Obstetrician-Gynecologist 2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991 Maternity Hospital "Amgalan", Ulan Bator, Mongolia A. G. Solopova Russian Federation Antonina G. Solopova – MD, Dr Sci Med, Professor, Department of Obstetrics, Gynecology and Perinatal Medicine Scopus Author ID: 6505479504 Researcher ID: Q-1385-2015 2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991 V. O. Bitsadze Russian Federation Victoria O. Bitsadze – MD, Dr Sci Med, Professor of RAS, Professor, Department of Obstetrics, Gynecologyand Perinatal Medicine Scopus Author ID: 6506003478 Researcher ID: F-8409-2017 2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991 J. Kh. Khizroeva Russian Federation Jamilya Kh. Khizroeva – MD, Dr Sci Med, Professor, Department of Obstetrics, Gynecology and Perinatal Medicine Scopus Author ID: 57194547147 Researcher ID: F-8384-2017 2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991 E. A. Son Russian Federation Elena A. Son – MD, PhD, Associate Professor, Department of Faculty Therapy № 1 Scopus Author ID: 19837664400 2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991 Sh. Kh. Zobaid Russian Federation Shirin Kh. Zobaid – Student 2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991 G. K. Bykovshchenko Russian Federation Georgy K. Bykovshchenko – 6th year Student 2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991

References

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Outcome instruments

EHP-30 VAS-pain

Condition tags

endometriosischronic_pelvic_pain

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