Surgery for deep endometriosis without involvement of digestive or urinary tracts: do not worry the patients!

Vallée A, Aurélie Vallée, Stéphane Ploteau, Ploteau S, Abo C, Carole Abo, Stochino-Loi E, Emanuela Stochino-Loi, Moatassim-Drissa S, Salwa Moatassim-Drissa, N Marty, Noémie Marty, Marty N, Benjamin Merlot, Merlot B, Horace Roman
Fertility and sterility · 2018 · vol. 109(6) , pp. 1079–1085.e1 · doi:10.1016/j.fertnstert.2018.02.124 · PMID:29935644 · W2808902800
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This study investigated surgical outcomes for patients with deep endometriosis, specifically excluding digestive or urinary tract involvement, and found that it is a safe procedure without major complications.

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Abstract

OBJECTIVE: To report postoperative outcomes after surgery for deep endometriosis without involvement of the digestive or urinary tracts. DESIGN: Retrospective study using data prospectively recorded in the North-West Inter Regional Female Cohort for Patients with Endometriosis (CIRENDO) database. SETTING: University tertiary referral center. PATIENT(S): One hundred thirty consecutive patients whose follow-up ranged from 1 to 6 years. INTERVENTION(S): Laparoscopic excision of deep endometriosis nodules. MAIN OUTCOME MEASURE(S): Postoperative complications were recorded in the CIRENDO database and medical charts. Postoperative digestive function was assessed using standardized gastrointestinal questionnaires: the Gastrointestinal Quality of Life Index and the Knowles-Eccersley-Scott Symptom Questionnaire. RESULT(S): Deep endometriosis nodules involved uterosacral ligaments, rectovaginal space, and vagina and spared the bowel, the bladder, and the ureters. Nodule size was 3 cm in diameter in 20.8%, 64.6%, and 14.6% of cases, respectively. Clavien-Dindo 1, 2, and 3b complications occurred in 0.8%, 4.6%, and 5.4% of cases, respectively. Among Clavien-Dindo 3b complications, most involved pelvic hematoma. Gastrointestinal scores revealed significant improvement in digestive function or defecation pain at 1 and 3 years after surgery. The pregnancy rate was, respectively, 43.3% and 56.7% at 1 and 3 years postoperatively, among which 66.7% and 64.7% were spontaneous conceptions. CONCLUSION(S): Our data suggest that surgery for deep endometriosis without involvement of the digestive or urinary tracts provides a low rate of postoperative complications and satisfactory fertility outcomes.

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Condition tags

endometriosischronic_pelvic_pain

MeSH descriptors

Endometriosis Peritoneal Diseases Postoperative Complications Postoperative Complications Adult Adult Endometriosis Endometriosis Endometriosis Female Female Fertility Fertility Fertility Follow-Up Studies Follow-Up Studies Gastrointestinal Diseases Gastrointestinal Diseases Gastrointestinal Diseases Humans

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (24)

Cited by (18)

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