Outcomes of Laparoscopic Surgery of Deep Infiltrating Endometriosis: A Prospective Cohort Study in Yas Infertility Center, Tehran: -

TL;DR

This study shows that laparoscopic surgery for deep infiltrating endometriosis improves quality of life, sexual function, and gastrointestinal symptoms in women.

Contribution

The study provides new evidence on the effectiveness of laparoscopic surgery in treating deep infiltrating endometriosis and its impact on quality of life and symptoms.

Findings

Laparoscopic surgery significantly reduced gastrointestinal symptoms like pain, bloating, and constipation.

The surgery improved sexual function and general quality of life, particularly reducing pain scores.

Surgical complications were reported, including hemoglobin drop and intestinal injury.

Abstract

Endometriosis is a prevalent medical condition that significantly
affect the quality of life in a substantial proportion of women, affecting
their
fertility and manifesting with many symptoms like gastrointestinal symptoms.
The
present study aimed to evaluate the impact of laparoscopic surgery for
endometriosis on general and sexual quality of life, and gastrointestinal
symptoms in patients diagnosed with deep infiltrating endometriosis (DIE).

This prospective cohort study was conducted on 129 women
diagnosed with DIE-associated infertility and referred to Yas Infertility
Center
in Tehran , from 2022 to 2023. Demographic data and the presence and
severity of
gastrointestinal symptoms were recorded. These symptoms were reassessed one
month following endometriosis surgery. Participants were also asked to
complete
the SF-36 Quality of Life Questionnaire and Female Sexual Function Index
(FSFI)
questionnaires before the surgical procedure and one month later. Data were
analyzed using SPSS version 24.

This study of 129 patients (mean age
34.82±5.83 years, BMI 25.64±3.77 kg/m²) revealed near-universal ovarian
involvement (99.2%) and adhesions (99.2%), primarily affecting rectosigmoid
(24.1%) and cervix (29.5%). Pre-intervention, 98.4% reported abdominal pain
(47.3% severe), 37.9% bloating, and 24.8% constipation. Post-intervention
showed
dramatic improvements: pain-free cases rose to 90.7%, bloating reduced to
9.3%,
and constipation to 6.2% (all P0.0001). The FSFI score increased (57.6±28.8
to
65.2±27.4, P0.0001), and SF-36 pain scores halved (6.8±1.2 to 2.7±0.9,
P0.0001),
though vitality and emotional well-being remained unchanged. Surgical
complications included hemoglobin drop (17.8%) and intestinal injury (6.2%).

The findings of this study indicate that laparoscopic treatment of
DIE not only alleviates gastrointestinal symptoms but also significantly
enhances the quality of life and sexual function in affected women.