Nerve-sparing Surgery for Deep Infiltrating Endometriosis
Nerve-sparing surgical techniques for infiltrative retrocervical endometriosis improve the postoperative period and reduce complications.
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This paper evaluated laparoscopic nerve-sparing surgery versus a classical surgical technique for deep infiltrating (retro-cervical) endometriosis in 118 histologically verified patients, using an observational longitudinal prospective design with a retrospective component. In the main group (n=71) a modified nerve-sparing method preserved branches of the hypogastric nerves, while the control group (n=47) underwent conventional surgery, and outcomes were assessed by postoperative pain changes (first 24 hours and up to 6 months) and early (first day) and later (6 months) episodes of bladder and bowel dysfunction, with follow-up reported to 12 months. Compared with controls, the nerve-sparing group had significantly less blood loss, shorter operative time, and shorter hospitalization; by 12 months both groups showed significant reductions in dysmenorrhea, dyspareunia, and chronic pelvic pain, but immediately after surgery controls had more bladder atony and at 6 months controls reported persistently reduced defecation urge. This paper is centrally about endometriosis — it specifically studies nerve-sparing laparoscopic surgery for deep infiltrating retrocervical endometriosis.
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