Endometriosis Surgery Improves Sex Life

This is according to the results of a study that evaluated the long-term effects of laparoscopic excision surgery for the treatment of deep infiltrating endometriosis.

Key Points

Highlights:

• The sexual quality of life and health-related quality of life of women with deep infiltrating endometriosis improved following laparoscopic excision surgery and were similar to that of healthy women after six months.
• They showed a slight reduction three years after the surgery.

Importance:

• These findings can guide decision-making as to the best way to manage deep infiltrating endometriosis.

What's done here:

• Researchers in Spain used four different questionnaires to assess the sexual quality of life and health-related quality of life of women with deep infiltrating endometriosis who underwent laparoscopic excision surgery as compared to healthy women.

Key results:

• The sexual quality of life and health-related quality of life of women with deep infiltrating endometriosis is significantly reduced compared to healthy women.
• The sexual and health-related quality of life of women with deep infiltrating endometriosis improves following laparoscopic excision surgery and is comparable to that of healthy women six months after surgery.
• The improvements remain three years following surgery with only a slight reduction compared to six months after surgery.

Limitations

• Researchers only evaluated the healthy women before laparoscopic tubal ligation surgery and there is no information about how the surgery affected their sexual and health-related quality of life.
• Deep infiltrating endometriosis patients included in this study may have had more severe disease than the general endometriosis population due to the fact that the study was conducted in a tertiary hospital and the findings might not apply to all patients with the disease.
• Women with deep infiltrating endometriosis received more frequent hormonal treatment, which may have had an influence on sexual outcomes.

Lay Summary

Women who underwent laparoscopic resection surgery to treat their deep infiltrating endometriosis had improved sexual quality of life and health-related quality of life according to a new study published in the Journal of Minimally Invasive Gynecology.

These findings are important because they can help guide the right standard of care in the surgical treatment of deep infiltrating endometriosis.

In order to investigate the long-term effects of laparoscopic excision surgery to treat deep infiltrating endometriosis on the sexual quality of life and health-related quality of life of sexually active women, a team of researchers led by Dr. Francisco Carmona performed a prospective case-control study in Spain.

The researcher recruited 200 patients at the Hospital Clinic of Barcelona. More than half of the women (129) had deep infiltrating endometriosis while 64 were healthy and underwent tubal ligation. Seven women were excluded because they refused to participate in the study or because they had peritoneal endometriosis. All women were operated on using laparoscopy. Those with deep infiltrating endometriosis had laparoscopic endometriosis surgery. 

The team used the medical outcomes study 36-Item short form (SF-36) questionnaire to evaluate the women’s health-related quality of life. They also used three questionnaires to assess the women’s sexual quality of life. These were the generic sexual quality of life-female (SQOL-F), the female sexual distress scale (FSDS), and the brief profile of female sexual function (B-PFSF). Different aspects of sexual quality of life were assessed including sexually related distress and hypoactive sexual desire disorder, which is defined as persistently or recurrently deficient or absent sexual fantasies and desire for sexual activity.

All women answered all four questionnaires before their surgery. Those with deep infiltrating endometriosis also completed the questionnaires six months and three years after their surgery. 

The results showed that, based on their answers to the questionnaires before surgery, women with deep infiltrating endometriosis had significant impairment in sexual quality of life and health-related quality of life. However, six months following surgery, women with deep infiltrating endometriosis who underwent laparoscopic endometriosis excision surgery had scores comparable to healthy women.  Three years following endometriosis surgery the scores of women who underwent endometriosis surgery were still higher compared to what they were before surgery but there was a slight decrease compared to six months.

“[Sexual quality of life] and [health-related quality of life] improved in deep infiltrating endometriosis patients undergoing complete laparoscopic endometriosis resection," the authors concluded.

Research Source: https://pubmed.ncbi.nlm.nih.gov/33984510/