Byrne, D;
Curnow, T;
Smith, P;
Cutner, A;
Saridogan, E;
Clark, TJ;
(2018)
Laparoscopic excision of deep rectovaginal endometriosis in BSGE endometriosis centres: a multicentre prospective cohort study.
BMJ Open
, 8
(4)
, Article e018924. 10.1136/bmjopen-2017-018924.
Preview |
Text
Laparoscopic excision of deep rectovaginal endometriosis in BSGE endometriosis centres a multicentre prospective cohort stud.pdf - Published Version Download (260kB) | Preview |
Abstract
Objective: To estimate the effectiveness and safety of laparoscopic surgical excision of rectovaginal endometriosis. / Design: A multicentre, prospective cohort study. / Setting: 51 hospitals accredited as specialist endometriosis centres. / Participants: 5162 women of reproductive age with rectovaginal endometriosis of which 4721 women had planned laparoscopic excision. / Interventions: Laparoscopic surgical excision of rectovaginal endometriosis requiring dissection of the pararectal space. / Main outcome measures: Standardised symptom questionnaires enquiring about chronic pelvic pain, bladder and bowel symptoms, analgesia use and quality of life (EuroQol) completed prior to surgery and at 6, 12 and 24 months postoperatively. Serious perioperative and postoperative complications including major haemorrhage, infection and visceral injury were recorded. / Results: At 6 months postsurgery, there were significant reductions in premenstrual, menstrual and non-cyclical pelvic pain, deep dyspareunia, dyschezia, low back pain and bladder pain. In addition, there were significant reductions in voiding difficulty, bowel frequency, urgency, incomplete emptying, constipation and passing blood. These reductions were maintained at 2 years, with the exception of voiding difficulty. Global quality of life significantly improved from a median pretreatment score of 55/100 to 80/100 at 6 months. There was a significant improvement in quality of life in all measured domains and in quality-adjusted life years. These improvements were sustained at 2 years. All analgesia use was reduced and, in particular, opiate use fell from 28.1% prior to surgery to 16.1% at 6 months. The overall incidence of complications was 6.8% (321/4721). Gastrointestinal complications (enterotomy, anastomotic leak or fistula) occurred in 52 (1.1%) operations and of the urinary tract (ureteric/bladder injury or leak) in 49 (1.0%) procedures. / Conclusion: Laparoscopic surgical excision of rectovaginal endometriosis appears to be effective in treating pelvic pain and bowel symptoms and improving health-related quality of life and has a low rate of major complications when performed in specialist centres.
| Type: | Article |
|---|---|
| Title: | Laparoscopic excision of deep rectovaginal endometriosis in BSGE endometriosis centres: a multicentre prospective cohort study |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1136/bmjopen-2017-018924 |
| Publisher version: | https://doi.org/10.1136/bmjopen-2017-018924 |
| Language: | English |
| Additional information: | This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health > Reproductive Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10109066 |
Archive Staff Only
 |
View Item |
