Document Detail


Radical resection of invasive endometriosis with bowel or bladder involvement--long-term results.
MedLine Citation:
PMID:  16102887     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: With the present study we wanted to evaluate the effect of a radical resection of bowel and bladder endometriosis with respect to relief of pain symptoms and long-term effects. STUDY DESIGN: Retrospectively we analyzed 23 patients undergoing bowel or bladder resection for infiltrating endometriosis between 1995 and 2004. Chart review was performed and data were analyzed with respect to pain symptoms, fertility, type of surgery, operative morbidity and mortality. At 1, 3 and 5 years of follow-up patients were asked to evaluate their symptoms based on a visual analogue pain scale (0: no pain, 10: most severe pain). Results were compared using the Student's t-test. RESULTS: Leading symptoms were chronic pelvic pain (17/23, 73.9%), dysmenorrhea (11/23, 47.8%), dyspareunia (6/23, 26.1%), infertility (4/23, 17.4%) and dyschezia (4/23, 17.4%). Three patients (13%) had abdominal hysterectomy, 5 (21.7%) LSO (n = 2) or BSO (n = 3), 18 (78.3%) anterior rectal resection, 4 (17.4%) sigmoid resection, 2 (8.6%) segmental bladder resection and one patient (4.3%) cecal resection. Major complications requiring re-operation occurred in three patients (2x postoperative bleeding, 1x anastomosis break-down). During follow-up (mean 40.5 months) 21 of the 23 patients (91.3%) had a persistent improvement of symptoms, 8 of the 23 (34.8%) had recurrent symptoms with a mean symptom-free interval of 40.4 months after surgery (24-60 months). No patient developed dyspareunia or dyschezia during follow-up. Overall cure rate was 73.9%. Four patients became pregnant (23%). Average pain scores increased during follow-up period but still remained significantly below the initial score (p < 0.001). CONCLUSION: Radical surgery for deep endometriosis with bowel or bladder involvement leads to a reliable and persistent relief of pain symptoms. Especially deep dyspareunia and dyschezia might be eliminated by this procedure.
Authors:
Markus C Fleisch; Dimitris Xafis; Filip De Bruyne; Juergen Hucke; Hans Georg Bender; Peter Dall
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Publication Detail:
Type:  Journal Article     Date:  2005-08-15
Journal Detail:
Title:  European journal of obstetrics, gynecology, and reproductive biology     Volume:  123     ISSN:  0301-2115     ISO Abbreviation:  Eur. J. Obstet. Gynecol. Reprod. Biol.     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2005-11-30     Completed Date:  2006-03-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0375672     Medline TA:  Eur J Obstet Gynecol Reprod Biol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  224-9     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Heinrich-Heine-University, Moorenstr. 5, D-40225 Duesseldorf, Germany. fleisch@med.uni-duesseldorf.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Endometriosis / complications,  surgery*
Female
Follow-Up Studies
Humans
Intestinal Diseases / etiology,  surgery*
Pain / diagnosis,  etiology,  surgery
Pain Measurement
Retrospective Studies
Surgical Procedures, Operative
Treatment Outcome
Urinary Bladder Diseases / etiology,  surgery*

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


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