Department of Obstetrics and Gynecology, Ospedale Sacro Cuore, Via Don Sempreboni 5, Negrar, Verona, Italy.
Reprod Biomed Online. 2010 May;20(5):602-9. doi: 10.1016/j.rbmo.2009.12.029. Epub 2010 Feb 1.
Bowel resection for endometriosis improves pain symptoms and quality of life in symptomatic women. However, little is known about fertility after surgery, particularly after such treatment in women suffering from infertility. The aim of the present study was to evaluate post-operative fertility and long-term clinical outcome after laparoscopic colorectal resection for endometriosis in infertile women. This study reports clinical outcomes in 62 infertile women who underwent laparoscopic excision of endometriosis with segmental bowel resection performed for severe intestinal symptoms. Among women younger than 30 years trying to conceive spontaneously, the cumulative pregnancy rate was 58% and the cumulative pregnancy rate was 45% in those aged 30-34 years. The total pain recurrence was 9.7% (six cases) and endometriosis recurrence was diagnosed by ultrasound in 14.5% (nine cases) during the follow-up period. Four of these patients needed further surgery because of severe symptoms. The surgical treatment of bowel endometriosis seems to improve pain symptoms and patients' satisfaction rates, and it could also be indicated in infertile women.
肠切除术治疗子宫内膜异位症可改善有症状女性的疼痛症状和生活质量。然而,对于手术后的生育能力,特别是对于患有不孕症的女性的手术后生育能力,了解甚少。本研究旨在评估腹腔镜结直肠子宫内膜异位症切除术治疗不孕症患者的术后生育能力和长期临床结局。本研究报告了 62 例因严重肠道症状而行腹腔镜切除子宫内膜异位症合并肠段切除术的不孕女性的临床结局。在试图自然受孕的年龄小于 30 岁的女性中,累积妊娠率为 58%,年龄在 30-34 岁的女性中,累积妊娠率为 45%。总疼痛复发率为 9.7%(6 例),在随访期间,14.5%(9 例)通过超声诊断为子宫内膜异位症复发。其中 4 例因严重症状需要进一步手术。肠子宫内膜异位症的手术治疗似乎可以改善疼痛症状和患者的满意度,并且也可以用于治疗不孕的女性。