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腹腔镜手术治疗深部浸润性子宫内膜异位症患者的长期性生活质量随访。

Long-term Follow-up of Sexual Quality of Life after Laparoscopic Surgery in Patients with Deep Infiltrating Endometriosis.

机构信息

Department of Gynaecology, Institute Clinic of Gynaecology, Obstetrics and Neonatology, Hospital Clinic, Faculty of Medicine, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain (all authors).

Department of Gynaecology, Institute Clinic of Gynaecology, Obstetrics and Neonatology, Hospital Clinic, Faculty of Medicine, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain (all authors).

出版信息

J Minim Invasive Gynecol. 2021 Nov;28(11):1912-1919. doi: 10.1016/j.jmig.2021.04.023. Epub 2021 May 11.

Abstract

STUDY OBJECTIVE

We performed a long-term follow-up to quantify the impairment of sexual quality of life (SQL) and health-related QL (HRQL) in sexually active women after laparoscopic excision of deep infiltrating endometriosis (DIE).

DESIGN

Prospective case-control study.

SETTING

Hospital Clinic of Barcelona.

PATIENTS

A total of 193 patients (after dropout and exclusions) were divided into 2 groups: one hundred twenty-nine premenopausal women with DIE (DIE group) and 64 healthy women who underwent tubal ligation (C group).

INTERVENTIONS

All patients underwent laparoscopic surgery: laparoscopic endometriosis surgery in the DIE group and laparoscopic tubal ligation in the C group. All women were followed for at least 36 months, and they completed the Medical Outcomes Study 36-item short form questionnaire to assess their HRQL and 3 self-administered questionnaires that evaluate different aspects of SQL: the generic Sexual Quality of Life-Female questionnaire, the Female Sexual Distress Scale to evaluate "sexually related distress," and the Brief Profile of Female Sexual Function to screen hypoactive sexual desire disorder. The patients with DIE as well as the controls completed the 4 questionnaires before surgery, and the patients with DIE also completed the questionnaires at 6 and 36 months after surgery.

MEASUREMENTS AND MAIN RESULTS

A comparison of the patients and controls before surgery showed a statistically significant impairment in SQL and HRQL among the patients with DIE. A statistically significant improvement in SQL and HRQL was observed in the DIE group 6 months after surgery, with scores being similar to those of the C group. An evaluation 36 months after surgery showed that SQL and HRQL were better than presurgical SQL and HRQL in the DIE group, with a slight reduction compared with the 6-month evaluation.

CONCLUSION

SQL and HRQL improved in patients with DIE undergoing complete laparoscopic endometriosis resection and were comparable to those of healthy women at 6 months after surgery, showing a slight reduction at 36 months of follow-up.

摘要

研究目的

我们进行了一项长期随访,以量化腹腔镜切除深部浸润性子宫内膜异位症(DIE)后活跃女性的性健康相关生活质量(SQL)和健康相关生活质量(HRQL)的损害。

设计

前瞻性病例对照研究。

地点

巴塞罗那临床医院。

患者

共有 193 名患者(在排除和排除后)分为两组:129 名患有 DIE 的绝经前妇女(DIE 组)和 64 名接受输卵管结扎的健康妇女(C 组)。

干预措施

所有患者均接受腹腔镜手术:DIE 组行腹腔镜子宫内膜异位症手术,C 组行腹腔镜输卵管结扎术。所有女性至少随访 36 个月,并完成医疗结果研究 36 项简明健康调查问卷,以评估其 HRQL 和 3 项自我管理问卷,评估 SQL 的不同方面:通用女性性健康问卷、评估“与性相关的困扰”的女性性困扰量表,以及筛查性欲减退障碍的女性性功能简要概况。DIE 患者和对照组在术前完成了 4 项问卷,DIE 患者还在术后 6 个月和 36 个月完成了问卷。

测量和主要结果

术前患者与对照组比较,DIE 患者 SQL 和 HRQL 明显受损。DIE 组术后 6 个月 SQL 和 HRQL 有统计学显著改善,评分与 C 组相似。术后 36 个月评估显示,DIE 组 SQL 和 HRQL 优于术前,与术后 6 个月评估相比略有下降。

结论

DIE 患者行完全腹腔镜子宫内膜异位症切除术可改善 SQL 和 HRQL,术后 6 个月与健康女性相当,随访 36 个月略有下降。

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