Abstract

Objective

To assess the influence of surgical approach, complications and patient characteristics and their postoperative functional outcomes on (sexual) quality of life (QoL) in patients with deep endometriosis (DE) with bowel involvement.

Methods

Retrospective cohort study on patients surgically treated for DE in a Dutch tertiary referral hospital. Data are based on surgical records and questionnaires covering current postoperative bowel function and (sexual) QoL.

Results

Postoperative functional score outcomes: constipation, fecal incontinence and Low Anterior Resection Syndrome (LARS) did not differ between patients treated with rectal shaving or segmental resection. Thirty percent of women treated with rectal shaving experienced LARS-like symptoms as well. Women who underwent segmental resection had a worse sexual QoL compared to patients managed by shaving. Patients who suffered from complications had a worse postoperative QoL. A higher postoperative constipation score was correlated with a significantly higher pain score and a lower overall and sexual QoL. LARS-score was correlated with a worsened sexual QoL.

Conclusion

Women who underwent surgery for deep endometriosis rated their overall QoL as lower when a complication occurred. Segmental resection resulted in a lower sexual QoL compared to shaving. We showed that a higher LARS-score correlates with a lower sexual QOL, and postoperative constipation with more pain and a lower overall and sexual QoL. Interestingly, after using the shaving technique one-third of the patients experienced LARS-like symptoms as well.

中文翻译：

---

深部子宫内膜异位症手术后的肠功能和生活质量

摘要

客观的

评估手术方法、并发症和患者特征及其术后功能结果对伴有肠道受累的深部子宫内膜异位症 (DE) 患者（性）生活质量 (QoL) 的影响。

方法

在荷兰三级转诊医院接受手术治疗 DE 患者的回顾性队列研究。数据基于涵盖当前术后肠道功能和（性）生活质量的手术记录和问卷。

结果

Postoperative functional score outcomes: constipation, fecal incontinence and Low Anterior Resection Syndrome (LARS) did not differ between patients treated with rectal shaving or segmental resection. Thirty percent of women treated with rectal shaving experienced LARS-like symptoms as well. Women who underwent segmental resection had a worse sexual QoL compared to patients managed by shaving. Patients who suffered from complications had a worse postoperative QoL. A higher postoperative constipation score was correlated with a significantly higher pain score and a lower overall and sexual QoL. LARS-score was correlated with a worsened sexual QoL.

Conclusion

发生并发症时，接受深部子宫内膜异位症手术的女性认为她们的整体生活质量较低。与剃须相比，节段性切除导致较低的性生活质量。我们发现较高的 LARS 评分与较低的性生活质量相关，术后便秘与更多的疼痛以及较低的整体生活质量和性生活质量相关。有趣的是，在使用剃须技术后，三分之一的患者也出现了类似 LARS 的症状。