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

Jolyon Ford, Ford J, English J, James English, Miles WA, William A. Miles, Giannopoulos T, 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

endometriosisbowel_endometriosisdysmenorrheadyspareunia

MeSH descriptors

Endometriosis Pain Rectal Diseases Vaginal Diseases Adult Adult Chronic Disease Chronic Disease Endometriosis Endometriosis Female Female Humans Humans Hysterectomy Hysterectomy Hysterectomy Hysterectomy Infant Infant

Citation neighborhood (2-hop)

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 (20)

Cited by (50)

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