Pain, quality of life and complications following the radical resection of rectovaginal endometriosis

Jolyon Ford, James English, William A Miles, Theo Giannopoulos
BJOG: An International Journal of Obstetrics & Gynaecology · 2004 · vol. 111(4) , pp. 353–356 · doi:10.1111/j.1471-0528.2004.00093.x · PMID:15008772 · W2002506102
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This study found that radical resection is an effective treatment for rectovaginal endometriosis, with hysterectomy and rectal resection associated with improved outcomes and quality of life.

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Abstract

OBJECTIVE: To determine the long term response, quality of life and levels of pain following the radical excision of rectovaginal endometriosis. DESIGN: A cohort study. SETTING: A tertiary referral centre for the management of advanced endometriosis. SAMPLE: All patients who had undergone radical resection. METHODS: Case note review and patient questionnaire. MAIN OUTCOME MEASURES: Surgical complications. Overall improvement. Dysmenorrhoea, dyspareunia, dyschezia and chronic pain were measured using a visual analogue scale. Quality of life was measured using the EQ-5D questionnaire. RESULTS: Twelve radical resections were performed by laparotomy, 48 by laparoscopy. Ten patients had a hysterectomy. Forty-eight patients underwent shaving of the pre-rectal fascia, two had a disc resection of the rectum, 10 had an anterior rectal resection. Two patients required a colostomy and two needed subsequent dilation of a stenosed anastomosis. Forty-four of the first 46 patients replied. The median follow up period was 12 months (range 2 to 22 months) and 86% (38/44) reported an improvement or whom 27 (61%) had a good response (pain completely gone or greatly improved). Patients having a hysterectomy or a disc or segmental resection of the rectum reported a good response and had a normal quality of life. Quality of life scores in the study group overall were lower than the background population. CONCLUSIONS: Radical resection is an effective treatment for rectovaginal endometriosis. Hysterectomy and rectal resection were associated with a better response and quality of life.

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Condition tags

mesh:D004715endometriosisbowel_endometriosisdysmenorrheadyspareunia

MeSH descriptors

Endometriosis Pain Rectal Diseases Vaginal Diseases Adult Chronic Disease Endometriosis Female Humans Hysterectomy Hysterectomy Hysterectomy Infant Laparoscopy Laparoscopy Laparoscopy Laparotomy Laparotomy Laparotomy Length of Stay

Citation neighborhood

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. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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Cited by (50)

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