Avaliação da função intestinal, qualidade de vida e função sexual em mulheres com endometriose infiltrativa profunda

Introduction:Endometriosis is a chronic disease that affects 10% of women of reproductive age.Deep infiltrating endometriosis can affect the bowel, causing intestinal and painful symptoms that impair quality of life.Surgery is an option to treat these women.Although some studies point to improving quality of life, it is not known for sure whether this procedure would interfere with intestinal function and thus could impair quality of life and sexual function.Therefore, more studies should focus on intestinal function of these women and correlate with their quality of life and sexual function to improve the treatment of this pathology.Objective: Comparison among bowel function, quality of life and sexual function in deep endometriosis women treated by surgery or clinical treatment only.Methods: Cross-sectional study, carried out with 141 women with endometriosis, followed at the University of Campinas from May/2020 to April/2021.Those women were divided into two groups according to kind of treatment: 51 women with surgical treatment (35 underwent radical surgery and 16 underwent conservative surgery) and 90 women with clinical treatment.The Endometriosis Health Profile Questionnaire (EHP-30) and Female Sexual Function Index (FSFI) were used to assess quality of life and sexual function, respectively.To access bowel function we used the following questionnaires: The Bristol Stool Scale, The Bowel Function in the Community, the Gastrointestinal Quality of Life Index (GIQLI) and Pelvic Floor Distress Inventory (PFDI-20).All patients signed a detailed informed consent before participating in the study.Results: Age in the surgical group (37.985.91)was significatively higher than the clinical group (35.685.45)(p=0.006).The average period of treatment was 32,2429,37 months.All other variables did not show statistically significant differences between the two groups, including symptoms of pain (p=0.905)water intake (p=0.573) or fiber intake (p=0.407),physical activity (p=0.792) and Body Mass Index (BMI) (p=0.407).When analysing intestinal function, constipation was more prevalent in women that undewent surgery as treatment of choice compared to women treated clinically, 84.31% versus 63.92%, respectively (p=0.009).Quality of life and sexual function were uniform comparing both groups.Women presented similar scores of gastrointestinal quality of life (p=0,27) and of pelvic floor distress inventory (p=0,23).Women in surgical group presented higher frequency of evacuatory effort and changes in posture to evacuate (p=0,01 and 0,009, respectively) than other groups (clinical and conservative surgery).Constipated women had worse quality of life and more pain than those whit normal bowel movements, showing positive correlation between quality of life and bowel function.The worst bowel function, the worst quality of life (p<0.001).In our study, both groups presented sexual dysfunction.(FSFI 21.067.75and 20.169.11respectively). Conclusion:Clinical and surgical treatment are important choices of treatment for women that suffers from dysfunctional symptoms.Both alternatives upgrade pain symptoms, quality of life and sexual function, despite bowel surgery causes more constipation, it is an alternative to nonresponses of clinical therapy.