Improvement of Post-Operative Quality of Life in Patients 2 Years after Minimally Invasive Surgery for Pain and Deep Infiltrating Endometriosis

Abstract

This study addressed the improvement in the quality of life of patients 2 years after minimally invasive surgery for painful deep infiltrating endometriosis (DIE), evaluated with EHP-5 (Endometriosis Health Profile-5) scores and the intensity of dysmenorrhea and dyspareunia. This was a retrospective study, performed in a referral centre for endometriosis, between January 2010 and January 2019. EHP-5 scores were complete for 54 patients, and two subgroups were analysed: classic laparoscopy (CL) vs. robotic laparoscopy (RL), and conservative surgery (ConservS) vs. total surgery (TS). There was an important decrease in 2-year post-operative EHP-5 scores in the global population (pre-op: 61.36 (42.18–68.75) and 2-year post-op: 20.45 (0–38.06); p < 0.001). The Visual Analogic Scale (VAS) was also lower for dysmenorrhea (pre-op: 8 (7–9.75) vs. 2-year post-op: 3 (2–5.25); p < 0.001) and dyspareunia (pre-op: 6 (3.1–8.9) vs. 2-year post-op: 3 (0–6); p < 0.001). In the subgroup analysis, EHP-5 scores were improved in the RL group (pre-op: 65.9 (59.09–71.02) vs. 2-year post-op: 11.4 (0–38.06); p < 0.001) and the CL group (pre-op: 50 (34.65–68.18) vs. 2-year post-op: 27.27 (14.20–40.90); p < 0.001), with a slight advantage for RL (p = 0.04), and the same improvements were found for ConservS (pre-op: 61.4 (38.06–71.59) vs. 2-year post-op: 22.7 (11.93–38.07); p < 0.001) and TS groups (pre-op: 61.59 (51.70–68.75) vs. 2-year post-op: 13.63 (0–44.30); p < 0.001). Minimally invasive surgery improved the quality of life for DIE patients 2 years after surgery, and conservative surgery showed comparable results to total surgery.