In:
PLOS ONE, Public Library of Science (PLoS), Vol. 16, No. 4 ( 2021-4-23), p. e0250046-
Abstract:
To assess individual changes of deep dyspareunia (DDyspareunia) six months after laparoscopic nerve-sparing complete excision of endometriosis, with or without robotic assistance. Methods This preplanned interdisciplinary observational study with a retrospective analysis of intervention enrolled 126 consecutive women who underwent surgery between January 2018 and September 2019 at a private specialized center. Demographics, medical history and surgery details were recorded systematically. DDyspareunia (primary outcome), dysmenorrhea and acyclic pelvic pain were assessed on self-reported 11-point numeric rating scales both preoperatively and at six-month follow-up. Cases with poor prognosis in relation to dyspareunia were described individually in greater detail. Results Preoperative DDyspareunia showed weak correlation with dysmenorrhea (rho = .240; P = .014) and pelvic pain (rho = .260; P = .004). Although DDyspareunia improved significantly (P 〈 .001) by 3 points or more in 75.8% (95%CI: 64.7–86.2) and disappeared totally in 59.7% of cases (95%CI:47.8–71.6), individual analysis identified different patterns of response. The probability of a preoperative moderate/severe DDyspareunia worsening more than 2 points was 4.8% (95%CI: 0.0–10.7) and the probability of a woman with no DDyspareunia developing “de novo” moderate or severe DDyspareunia was 7.7% (95%CI: 1.8–15.8) and 5.8% (95%CI: 0.0–13.0), respectively. In a qualitative analysis, several conditions were hypothesized to impact the post-operative DDyspareunia response; these included adenomyosis, mental health disorders, lack of hormone therapy after surgery, colporrhaphy, nodule excision in ENZIAN B compartment (uterosacral ligament/parametrium), the rectovaginal septum or the retrocervical region. Conclusion Endometriosis surgery provides significant improvement in DDyspareunia. However, patients should be alerted about the possibility of unsatisfactory results.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0250046
DOI:
10.1371/journal.pone.0250046.g001
DOI:
10.1371/journal.pone.0250046.g002
DOI:
10.1371/journal.pone.0250046.t001
DOI:
10.1371/journal.pone.0250046.t002
DOI:
10.1371/journal.pone.0250046.t003
DOI:
10.1371/journal.pone.0250046.t004
DOI:
10.1371/journal.pone.0250046.t005
DOI:
10.1371/journal.pone.0250046.s001
DOI:
10.1371/journal.pone.0250046.s002
DOI:
10.1371/journal.pone.0250046.r001
DOI:
10.1371/journal.pone.0250046.r002
DOI:
10.1371/journal.pone.0250046.r003
DOI:
10.1371/journal.pone.0250046.r004
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2021
detail.hit.zdb_id:
2267670-3
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