Quality of life and psychoemotional status in patients with external genital endometriosis

In: Obstetrics, Gynecology and Reproduction · 2022 · vol. 16(2) , pp. 122–133 · doi:10.17749/2313-7347/ob.gyn.rep.2022.283 · W4280628836
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Women with painful external genital endometriosis report a lower quality of life compared to those with painless forms, with active rehabilitation improving pain, mood, and activity levels.

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This study enrolled 160 reproductive-age women with laparoscopically and morphologically verified external genital endometriosis, including 110 with painful and 50 with painless forms, and assessed pain and psychoemotional status with VAS, Endometriosis Health Profile-30 (EHP-30), and the Hospital Anxiety and Depression Scale (HADS) after surgical treatment. Women with painful EGE had a more severe disease course and markedly lower quality of life than those with painless EGE, and across four post-surgical rehabilitation groups, those receiving “active” rehabilitation measures showed decreased pain and improved emotional, social, and sexual activity with lower anxiety and depression scores compared with “passive” rehabilitation tactics. A stated limitation was participant attrition, with 8 of 160 women refusing to participate after surgery (6 with painful and 2 with painless EGE), leaving 152 for analysis. This paper is centrally about endometriosis — external genital endometriosis and how psychoemotional disorders relate to quality of life and outcomes after rehabilitation.

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Abstract

Introduction . Chronic pain syndrome with external genital endometriosis (EGE) causes profound psychoemotional changes, anxiety disorders, decreased physical and social activity, general well-being and mood, sexual dysfunction, and as a consequence, deteriorated quality of patients' life. Aim : to study an influence of psychoemotional disorders on the quality of life of women with painful and painless forms of EGE. Material and Methods . There were enrolled 160 patients (110 women with painful and 50 with painless forms of EGE) of reproductive age with laparoscopically and morphologically verified diagnosis, according to the Revised American Fertility Society score (R-AFS) classification. Pain syndrome and psychoemotional status were assessed using various quality of life assessment questionnaires: Visual Analog Scale (VAS), Endometriosis Health Profile-30 (EHP-30), Hospital Anxiety and Depression Scale (HADS). After surgical treatment, 8 patients refused to participate in the work (6 with painful form of EGE and 2 with painless form). Thus, 152 women passed all stages of the study. The patients were divided into 4 groups depending on the presence and/or absence of pain syndrome and tactics of the rehabilitation period ("active" or "passive"): group IA consisted of 49 (47.1 %) women with pain syndrome and "active" rehabilitation; group IБ – 55 (52.9 %) women with pain syndrome and "passive" rehabilitation tactics; group IIA – 23 (47.9 %) patients without pain syndrome and with "active" rehabilitation; group IIБ – 25 (52.1 %) patients without pain syndrome and with "passive" rehabilitation tactics. Results . It was found that painful vs. painless form of EGE differs by a more severe course of the disease and markedly decreased quality of life. In a comparative analysis of the four groups it was noted that women with "active" tactics of rehabilitation measures (IA and IIA) had a decrease in pain syndrome, improved emotional, social and sexual activity, decreased depression and anxiety scores as compared to the patients (IБ and IIБ) who underwent a set of rehabilitation measures within the National clinical guidelines. Conclusion. Timely diagnostics and correction of psychoemotional disorders will allow to develop a differentiated approach to provide specialized medical and psychological care and improve the quality of life of patients with EGE.
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Abstract

Introduction. Chronic pain syndrome with external genital endometriosis (EGE) causes profound psychoemotional changes, anxiety disorders, decreased physical and social activity, general well-being and mood, sexual dysfunction, and as a consequence, deteriorated quality of patients' life. Aim: to study an influence of psychoemotional disorders on the quality of life of women with painful and painless forms of EGE.

Material

and Methods. There were enrolled 160 patients (110 women with painful and 50 with painless forms of EGE) of reproductive age with laparoscopically and morphologically verified diagnosis, according to the Revised American Fertility Society score (R-AFS) classification. Pain syndrome and psychoemotional status were assessed using various quality of life assessment questionnaires: Visual Analog Scale (VAS), Endometriosis Health Profile-30 (EHP-30), Hospital Anxiety and Depression Scale (HADS). After surgical treatment, 8 patients refused to participate in the work (6 with painful form of EGE and 2 with painless form). Thus, 152 women passed all stages of the study. The patients were divided into 4 groups depending on the presence and/or absence of pain syndrome and tactics of the rehabilitation period ("active" or "passive"): group IA consisted of 49 (47.1 %) women with pain syndrome and "active" rehabilitation; group IБ – 55 (52.9 %) women with pain syndrome and "passive" rehabilitation tactics; group IIA – 23 (47.9 %) patients without pain syndrome and with "active" rehabilitation; group IIБ – 25 (52.1 %) patients without pain syndrome and with "passive" rehabilitation tactics. Results. It was found that painful vs. painless form of EGE differs by a more severe course of the disease and markedly decreased quality of life. In a comparative analysis of the four groups it was noted that women with "active" tactics of rehabilitation measures (IA and IIA) had a decrease in pain syndrome, improved emotional, social and sexual activity, decreased depression and anxiety scores as compared to the patients (IБ and IIБ) who underwent a set of rehabilitation measures within the National clinical guidelines. Conclusion. Timely diagnostics and correction of psychoemotional disorders will allow to develop a differentiated approach to provide specialized medical and psychological care and improve the quality of life of patients with EGE. About the Authors E. BegovichRussian Federation MD, Postgraduate Student, Department of Obstetrics and Gynecology, Filatov Clinical Institute of Children's Health 2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991, Russia A. G. Solopova Russian Federation MD, Dr Sci Med, Professor, Department of Obstetrics and Gynecology, Filatov Clinical Institute of Children's Health Scopus Author ID: 6505479504. Researcher ID: Q-1385-2015 2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991, Russia S. V. Khlopkova Russian Federation MD, Obstetrician-Gynecologist of the Highest Qualification Category, Head of the Department of Gynecology Moscow Healthcare Department; 2/44 Salyama-Adilya Str., Moscow 123423, Russia E. A. Son Russian Federation MD, PhD, Associate Professor, Department of Faculty Therapy № 1, Sklifosovsky Institute of Clinical Medicine Scopus Author ID: 19837664400 2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991, Russia L. E. Idrisova Russian Federation MD, PhD, Assistant, Department of Obstetrics and Gynecology, Filatov Clinical Institute of Children's Health 2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991, Russia

References

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Outcome instruments

EHP-30 VAS-pain

Condition tags

endometriosis

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