Surgical Management of Deep Infiltrating Endometriosis and Impact on Quality of Life

Objective: The purpose of this retrospective review study was to assess the impact of surgery and quality of life for patients presenting painful deep infiltrating endometriosis (DIE).
Patients and methods: All patients with histologically proved infiltrating endometriosis who had surgery from 1.01.2006 to 31.12.2010 at the Clinic of Obstetrics and Gynecology I, Tîrgu Mureș, Romania and the Department of Gynecology and Obstetrics of the Rouen University Hospital-Charles Nicolle, Rouen, France were included in the study. Surgical exeresis of endometriosis for patients with deep infiltrating endometriosis with GnRha (Gonadotrophin-releasing hormone) analogues treatment before and after the surgery.
Results: One-hundred-fourteen subjects underwent operative laparoscopy for deep infiltrating endometriosis. Involvement of urinary tract was confirmed in thirty patients and the colorectal localization in eighty-four patients. Intra-operative finding according to American Fertility Society reviewed-classification (AFSr) score revealed stage I 6 (5.3%), stage II 9 (7.9%), stage III 18 (15.8%), and stage IV 81 (71.1%).
Conclusion: Resection for deep endometriosis appears to relieve some symptoms. However, patients should be informed that pain may persist and that there is a risk of urinary and digestive side effects.