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  • Original Article

    Female Sexual Function in Women with Suspected Deep Infiltrating Endometriosis

    Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(3):115-120

    Summary

    Original Article

    Female Sexual Function in Women with Suspected Deep Infiltrating Endometriosis

    Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(3):115-120

    DOI 10.1055/s-0038-1639593

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    Abstract

    Objective

    To evaluate the quality of the sexual function of women with suspected deep infiltrating endometriosis.

    Methods

    A cross-sectional, observational and prospective study was conducted between May 2015 and August 2016, in which 67 patients with deep infiltrating endometriosis, suspected or diagnosed, were assessed for epidemiological and clinical characteristics, such as pain level through a visual analog scale (VAS), features of deep infiltrating endometriosis lesions and score on the Female Sexual Function Index (FSFI) before the onset of treatment. The statistical analysis was performed using the software STATA version 12.0 (StataCorp LLC, College Station, TX, USA) to compare the variables through multiple regression analysis.

    Results

    The average age of the patients was 39.2 years old; most patients were symptomatic (92.5%); and the predominant location of the deep infiltrating lesions was on the rectosigmoid colon (50%), closely followed by the retrocervical region (48.3%). The medianoverallscoreontheFSFIwas23.4;in67.2%of thecasesthescorewas26.5(cutoff point for sexualdysfunction). Deepdyspareunia(p = 0.000,confidenceinterval [CI]:0.64- 0.83) and rectosigmoid endometriosis lesions (p = 0.008, CI: 0.72-0.95) showed significant correlation with lower FSFI scores, adjusted by bladder lesion, patients’ ageand size of lesions. Deep dyspareunia (p = 0.003, CI: 0.49-0.86) also exhibited significant correlation with FSFI pain domain, adjusted by cyclic bowel pain, vaginal lesion and use of gonadotropin-releasing hormone (GnRH) analog. These results reflect the influence of deep dyspareunia on the sexual dysfunction of the analyzed population.

    Conclusion

    Most patients exhibited sexual dysfunction, and deep dyspareunia was the pelvic painful symptom that showed correlation with sexual dysfunction.

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  • Original Article

    Surgical Treatment of Intestinal Endometriosis: Outcomes of Three Different Techniques

    Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(7):390-396

    Summary

    Original Article

    Surgical Treatment of Intestinal Endometriosis: Outcomes of Three Different Techniques

    Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(7):390-396

    DOI 10.1055/s-0038-1660827

    Views1

    Abstract

    Objective

    To outline the demographic and clinical characteristics of patients with deep intestinal endometriosis submitted to surgical treatment at a tertiary referral center with a multidisciplinary team, and correlate those characteristics with the surgical procedures performed and operative complications.

    Methods

    A prospective cohort from February 2012 to November 2016 of 32 women with deep intestinal endometriosis operations. The variables analyzed were: age; obesity; preoperative symptoms (dysmenorrhea, dyspareunia, acyclic pain, dyschezia, infertility, urinary symptoms, constipation and intestinal bleeding); previous surgery for endometriosis; Enzian classification; size of the intestinal lesion; and surgical complications.

    Results

    Themean age was 37.75 (±5.72) years. A total of 7 patients (22%) had a prior history of endometriosis. The mean of the largest diameter of the intestinal lesions identified intraoperatively was of 28.12 mm (±14.29 mm). In the Enzian classification, there was a predominance of lesions of the rectum and sigmoid, comprising 30 cases (94%). There were no statistically significant associations between the predictor variables and the outcome complications, even after the multiple logistic regression analysis. Regarding the size of the lesion, there was also no significant correlation with the outcome complications (p = 0.18; 95% confidence interval [95%CI]:0.94-1.44); however, there was a positive association between grade 3 of the Enzia classification and the more extensive surgical techniques: segmental intestinal resection and rectosigmoidectomy, with a prevalence risk of 4.4 (p < 0.001; 95%CI:1.60-12.09).

    Conclusion

    The studied sample consisted of highly symptomatic women. A high prevalence of deep infiltrative endometriosis lesions was found located in the rectum and sigmoid region, and their size correlated directly with the extent of the surgical resection performed.

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    Surgical Treatment of Intestinal Endometriosis: Outcomes of Three Different Techniques

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