Sexual functioning, quality of life and pelvic pain 12 months after endometriosis surgery including vaginal resection

OBJECTIVE: To evaluate sexual function, quality of life and pelvic pain after endometriosis surgery including vaginal resection. DESIGN: Prospective observational study with 12 months follow up. SETTING: Regional central hospital and university hospital. POPULATION: Twenty-two patients with deep endometriotic nodules in the posterior fornix of the vagina undergoing complete excision of endometriosis, including vaginal resection. METHODS: Sexual functioning was measured with the McCoy Female Sexuality Questionnaire, quality of life with a generic questionnaire (15D) and pain with a 10-point visual analog scale. Questionnaires were completed before and 12 months after the surgery. Main outcome measures. Changes in sexual function scores, quality-of-life scores and pain. RESULTS: Twelve months after surgery, the sexual satisfaction score was higher (p= 0.03) and the sexual problems score lower (p= 0.04) compared with baseline values. Health-related quality-of-life scores for discomfort and symptoms (p= 0.001), distress (p= 0.04), vitality (p= 0.03) and sexual activity (p= 0.001), and the overall 15D score (p < 0.001), were significantly improved. The severity of all studied types of pain was significantly decreased (p < 0.05). CONCLUSIONS: Complete excision of endometriosis, including vaginal resection, seems to offer a significant improvement in sexual functioning, quality of life and pelvic pain in symptomatic patients with deeply infiltrating endometriotic nodules in the posterior fornix of the vagina. This surgery may be associated with complications and adverse new-onset symptoms, and should be performed only after thorough consultation with the patient.