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The Benefits of Radical Laparoscopic Surgery and a Modified Endometriosis Health Profile-36 (EHP-36) on Quality of Life

Author(s): Ekine A A, Fulop I, Rucz A, Koppan A, Siklos P, Koppan M

Objective: This study investigates the outcomes for women up to 2 years after radical laparoscopic excision of endometriosis, and its effect on quality of life (QoL) and wellbeing using a modified Endometriosis Health Profile-36 questionnaire (EHP-36).

Design: A prospective cohort clinical study.

Setting: Robert Károly Hospital, Budapest, Hungary, Endoscopic Unit.

Population: Eighty-seven patients with proven investigative signs, symptoms and complaints of invasive endometriosis undergoing hysterolaparoscopic surgery in the hospital between 1 January 2017 and 31 December 2018.

Method: This study proscribes the use of questionnaires on patient’s quality of life and wellbeing with postoperative follow-up (for 6, 12 and 24 months).

Result: All 87 patients completed the questionnaires (response rate was 100%). Mean age was 34.2 ± 5.9 years; the average age of onset of endometriosis was 24.5 ± 5.710 years (15–37). The majority of patients (n = 65, 74.7%) were in stages III and IV. A total of 72 patients (82.76%) frequently described their pain as a pricking pain. The NRS-11 pain score reduced from 94.8% with moderate to severe pain preoperatively to 18.4% with mild pain postoperatively. There was a significant improvement in the QoL in this regard (p <0.001). The VAS pain score decreased from 8 ± 2.11 (86.0%) moderate to severe pain preoperatively to 0.47 ± 1.24 (93.1%) negligible to no pain postoperatively (p <0.001). 58.45% (32/61) of women with infertility, became pregnant, live birth was 77.4% (24/61). Perception of QoL before surgery as very bad in 89.6% (78/87) of women and the perception of QoL significantly improved in 93.1% (81/87) of women after surgery. General wellbeing was rated very low by 93.1% (81/87) of women before surgery. Postoperative general wellbeing rated very well or good in 94.2% (82/87) of women. Significant improvements observed in sexual life with 77.85% (75/87) and 74.7% (65/87) of women rating it as good or very good (p <0.001), respectively.

Conclusion: Meticulous individualized radical laparoscopic surgical intervention showed tremendous improvement in patient wellbeing and QoL.

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