Pain, quality of life and complications following the radical resection of rectovaginal endometriosis
Article first published online: 16 FEB 2004
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 111, Issue 4, pages 353–356, April 2004
How to Cite
Ford, J., English, J., Miles, W. A. and Giannopoulos, T. (2004), Pain, quality of life and complications following the radical resection of rectovaginal endometriosis. BJOG: An International Journal of Obstetrics & Gynaecology, 111: 353–356. doi: 10.1111/j.1471-0528.2004.00093.x
- Issue published online: 4 MAR 2004
- Article first published online: 16 FEB 2004
Objective To determine the long term response, quality of life and levels of pain following the radical excision of rectovaginal endometriosis.
Design A cohort study.
Setting A tertiary referral centre for the management of advanced endometriosis.
Sample All patients who had undergone radical resection.
Methods Case note review and patient questionnaire.
Main outcome measures Surgical complications. Overall improvement. Dysmenorrhoea, dyspareunia, dyschezia and chronic pain were measured using a visual analogue scale. Quality of life was measured using the EQ-5D questionnaire.
Results Twelve radical resections were performed by laparotomy, 48 by laparoscopy. Ten patients had a hysterectomy. Forty-eight patients underwent shaving of the pre-rectal fascia, two had a disc resection of the rectum, 10 had an anterior rectal resection. Two patients required a colostomy and two needed subsequent dilation of a stenosed anastomosis. Forty-four of the first 46 patients replied. The median follow up period was 12 months (range 2 to 22 months) and 86% (38/44) reported an improvement or whom 27 (61%) had a good response (pain completely gone or greatly improved). Patients having a hysterectomy or a disc or segmental resection of the rectum reported a good response and had a normal quality of life. Quality of life scores in the study group overall were lower than the background population.
Conclusions Radical resection is an effective treatment for rectovaginal endometriosis. Hysterectomy and rectal resection were associated with a better response and quality of life.