RRM Academy Synopsis
Less pain followed rectovaginal endometriosis excision in most women
Most women had less pain a year or more after laparoscopic excision of rectovaginal endometriosis, a 2002 conference abstract on 84 women reports. About 8 out of 10 women who answered reported less pelvic pain. Most also reported less painful sex, painful bowel movements and period pain.
Key Findings
- The authors found 84 women in a database of 1,760 women with endometriosis. Each had laparoscopic excision of rectovaginal disease, with the pouch behind the uterus completely obliterated by disease.
- Pelvic pain was better in 45 of 58 women (78%), the same in 11 (19%) and worse in 2 (3%), P = 0.0001.
- Menstrual pain was better in 40 of 59 women (68%), and dyspareunia (painful sex) in 23 of 35 (66%), each P = 0.0001.
- Dyschezia (painful bowel movements) was better in 37 of 63 women (59%), and constipation in 33 of 62 (53%). Constipation was the same in 26 (42%).
- The abstract reports no significant morbidity.
Interpretation
The source is a one-page conference abstract from one surgical database, so methods are brief. Women scored symptoms on a five point scale before surgery and again by mailed questionnaire a year or more later (range 1 to 10 years). Only women who returned the questionnaire count, and no comparison group exists. The authors report the largest gains in women who ranked their symptoms as severe or debilitating before surgery.
RRM Context
Restorative reproductive medicine aims to treat the cause of pain, and excision removes the disease where it sits. A second abstract from Wright and a colleague in the same supplement asks whether the results repeat in a British group of 28 women.
Abstract not indexed.