Document Detail


Delayed functional outcomes associated with surgical management of deep rectovaginal endometriosis with rectal involvement: giving patients an informed choice.
MedLine Citation:
PMID:  20106836     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The aim of this study was to compare delayed functional digestive and urinary outcomes following two different surgical procedures used in the management of rectal endometriosis. METHODS: Women who had undergone surgical management of rectal endometriosis with at least 1 year of post-operative follow-up were included in a retrospective study. Post-operative symptoms were evaluated using specific questionnaires which focused on pelvic pain and functional outcomes. RESULTS: There were 41 women who underwent surgical treatment of symptomatic rectal endometriosis. Post-operative follow-up was completed over 26 +/- 13 months (range 12-53). Colorectal segmental resection was performed in 25 women (61%) and nodule excision in 16 (39%). An increase in the number of daily stools > or =3 was observed in 13 (52%) and 3 (19%) patients managed, respectively, by segmental resection and nodule excision (P = 0.02). Severe constipation (<1 stool/5 days) was recorded in three women having undergone segmental resection. The probabilities of being free of dysmenorrhea, dyspareunia and non-cyclic pain at 24 months in women managed by segmental resection and nodule excision were, respectively, 80% (95% CI: 55-92%), 65% (95% CI: 42-81%), 43% (95% CI: 23-62%) and 62% (95% CI: 34-81%), 81% (95% CI: 52-94), 69% (95% CI: 40-86%). When pain recurrences occurred, a significantly lower post-operative score for pain was observed in both groups. No significant difference in pain improvement was found between surgical procedures. CONCLUSION: Colorectal segmental resection appears to be associated with several unpleasant functional symptoms when compared with nodule excision. Information about functional outcomes should be provided to patients managed for rectal endometriosis, and should be considered when deciding on the most appropriate treatment of this disease.
Authors:
Horace Roman; Cecile Loisel; Benoit Resch; Jean Jacques Tuech; Patrick Hochain; Anne Marie Leroi; Loic Marpeau
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-01-26
Journal Detail:
Title:  Human reproduction (Oxford, England)     Volume:  25     ISSN:  1460-2350     ISO Abbreviation:  Hum. Reprod.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-17     Completed Date:  2010-06-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8701199     Medline TA:  Hum Reprod     Country:  England    
Other Details:
Languages:  eng     Pagination:  890-9     Citation Subset:  IM    
Affiliation:
Department of Gynecology and Obstetrics, Rouen University Hospital, Rouen, France. horace.roman@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Digestive System Surgical Procedures / methods
Dysmenorrhea / physiopathology
Dyspareunia / physiopathology
Endometriosis / physiopathology,  surgery*
Female
Gynecologic Surgical Procedures / methods
Humans
Pain / physiopathology
Rectal Diseases / physiopathology,  surgery*
Retrospective Studies
Treatment Outcome
Vaginal Diseases / physiopathology,  surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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