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Surgery for severe endometriosis1/15/2024 After treating this ailment with surgery or hormonal treatments for decades, specialists like Carmona believe that in the coming years, our understanding of the genetic causes of the disease and the integration of data made possible by artificial intelligence may offer new alternatives to patients, as well as a theory that will help to understand what we are trying to cure. “It is as if we were making a jigsaw puzzle, we are collecting pieces, but we don’t know what image we are looking for, we don’t have a model that makes sense of it all,” explains Francisco Carmona, head of the Gynecology Service at Hospital Clínic in Barcelona. All rights reserved.Up to 10% of women suffer from endometriosis, and yet this disease is still shrouded in mystery. There is no difference in outcome between the types of bowel surgery undertaken as long as all visible/palpable endometriosis is removed.īowel endometriosis Endometriosis surgery Quality of life Rectovaginal septum.Ĭopyright © 2016 AAGL. Pelvic clearance improves outcome and patients should be counseled accordingly. Surgery by an experienced multidisciplinary team results in significant improvement in pain, sexual function, and quality of life up to 1 year postoperatively. Severe rectovaginal endometriosis compromising the bowel can be treated surgically with experienced combined gynecologic and colorectal input with a low serious complication rate. There was no significant difference between any postoperative variables tested regardless of the type of bowel surgery. Additionally, they had higher quality of life scores and greater satisfaction with their treatment. At 12 months patients who had a pelvic clearance (hysterectomy with bilateral salpingo-oophorectomy) had significantly less pain with better bowel function. The results show significant improvement in almost all variables measured (p <. The serious perioperative and postoperative complication rate was 7.3%. In total, 137 patients had surgery, of which 100 completed follow-up to 12 months. A Mann-Whitney U test was used to compare the results between those who had pelvic clearance and those who did not. To compare preoperative and postoperative scores, a Freidman test was performed followed by a preoperative and 12-month postoperative Wilcoxon signed-rank test. Dysmenorrhea, dyspareunia, dyschezia, and chronic pain were measured using a visual analogue scale. Bowel symptoms were measured using the Gastrointestinal Quality of Life Index. The main outcome measures were quality of life using the Endometriosis Health Profile 30 and EuroQol-5 dimension questionnaires. Women with severe rectovaginal endometriosis compromising the bowel.Ĭomparison of preoperative data with a 2-, 6-, and 12-month follow-up was made for consecutive patients who underwent surgery for endometriosis with bowel involvement. Specialist referral center for the management of advanced endometriosis. Single-center prospective cohort study (Canadian Task Force classification II-2). Our aim was to determine the quality of life after radical excision of rectovagina endometriosis compromising the bowel. Although outcomes after surgery for severe endometriosis affecting the bowel have previously been studied and have shown improvement in generic quality of life indices and sexual function, few studies have evaluated bowel function or symptoms specific to endometriosis. Of those, 5.3% to 12% will have endometriosis affecting the bowel. Endometriosis can affect 10% of women at reproductive age.
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