[Efficacy and impact on quality of life of different drug treatments after partial resection of rectovaginal endometriosis]

Objective: To evaluate different postoperative medications as maintenance treatment for rectovaginal endometriosis (RVE) patients after conservative surgery. Methods: RVE patients who underwent transvaginal partial excision from January 2007 to September 2016 with regular outpatient follow-up were retrospectively screened. Those followed by a levonorgestrel-releasing intrauterine system (LNG-IUS) insertion or oral contraceptive drospirenone/ethinylestradiol (DRSP/EE) 3 mg/30 μg administration were enrolled. Variations in endometriosis-related pain, sexual function and quality of life were measured by visual analogue scale (VAS), female sexual function index (FSFI) and short form 36-item health survey (SF-36) respectively. Results: There were a total of 102 RVE patients with 48 (47.1%, 48/102) in LNG-IUS group and 54 (52.9%, 54/102) in DRSP/EE group included. A rapid and marked improvement was observed after 3 months postoperative medical treatment compared to preoperative in both groups (P<0.01). In dysmenorrhea, for LNG-IUS group (2.5±0.8) versus (7.6±1.3; P<0.01), for DRSP/EE group (2.7±0.6) versus (7.7±1.4; P<0.01); in FSFI, for LNG-IUS group (23.5±2.0) versus (21.0±2.7; P<0.01), for DRSP/EE group (23.4±1.2) versus (21.5±2.2; P<0.01); in SF-36, both groups had obvious improvements in physical component summary and mental component summary (P<0.01), for LNG-IUS group (74±13) versus (56±19), (75±13) versus (55±17), for DRSP/EE group (73±11) versus (59±15), (75±9) versus (54±14). These effects were maintained stably and progressively during postoperative medication at 6-, 12-, 24-month follow up. Conclusion: Transvaginal partial excision combined postoperative LNG-IUS or DRSP/EE treatment is a safe and viable technique to alleviate pain, improve sexual function and quality of life.