Abstract
Purpose
The present work aims at showing how dyspareunia linked to endometriosis can affect the life of fertile age women and how surgical treatment of endometriosis can relieve painful symptoms and consequently improve sex and social life.
Methods
From a cohort of 320 women with a clinical and instrumental diagnosis of pelvic endometriosis, 67 patients were selected. These patients had deep dyspareunia that underwent laparoscopic surgical treatment. All the patients had filled out a pre- and post-surgery questionnaire.
Results
Six months after laparoscopic treatment, a significant reduction of dyspareunia was recorded, per VAS scores. A statistically significant improvement in sex life was observed between the pre- and post-surgical condition: in particular, an increased number of coituses and of non-difficult coituses, a higher number of patients who declared that pain did not negatively affect sexual pleasure and of patients achieving orgasm.
Conclusions
The quality of the sex life in patients with endometriosis and dyspareunia showed significant improvement 6 months after laparoscopic treatment. In view of the diagnostic delay characterizing this disease and confirmed by our results, it is essential to involve a multidisciplinary team to assess all the signs and symptoms of endometriosis that may appear in a women of fertile age. This clinical approach is able to ensure a treatment that is as personalized as possible and an appropriate follow-up also with the objective of preserving reproductive performance.
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References
Eskenazi B, Warner ML (1997) Epidemiology of endometriosis. Obstet Gynecol Clin North Am 24:235–258
Berman JR (2005) Physiology of female sexual function and dysfunction. Int J Impot Res 17(Suppl 1):S44–S51
Basson R, Berman J, Burnett A, Derogatis L, Ferguson D, Fourcroy J, Goldstein I, Graziottin A, Heiman J, Laan E, Leiblum S, Padma-Nathan H, Rosen R, Segraves K, Segraves RT, Shabsigh R, Sipski M, Wagner G, Whipple B (2000) Report of the International consensus development conference on female sexual dysfunction: definitions and classifications. J Urol 163(3):888–893
Ferrero S, Esposito F, Abbamonte LH, Anserini P, Remorgida V, Ragni N (2005) Quality of sex life in women with endometriosis and deep dyspareunia. Fertil Steril 83(3):573–579
Abbott JA, Hawe J, Clayton RD, Garry R (2003) The effects and effectiveness of laparoscopic excision of endometriosis: a prospective study with 2-5 year follow-up. Human Reprod 18(9):1922–1927
Vercellini P, Somigliana E, Buggio L, Barbara G, Frattaruolo MP, Fedele L (2012) “I can’t get no satisfaction”: deep dyspareunia and sexual functioning in women with rectovaginal endometriosis. Fertil Steril 98(6):1503–1511
Ferrero S, Abbamonte LH, Giordano M, Ragni N, Remorgida V (2007) Deep dyspareunia and sex life after laparoscopic excision of endometriosis. Human Reprod 22(4):1142–1148
Fauconnier A, Chapron C, Dubuisson JB, Vieira M, Dousset B, Bréart G (2002) Relation between pain symptoms and the anatomic location of deep infiltrating endometriosis. Fertil Steril 78(4):719–726
Chopin N, Vieira M, Borghese B, Foulot H, Dousset B, Coste J, Mignon A, Fauconnier A, Chapron C (2005) Operative management of deeply infiltrating endometriosis: results on pelvic pain symptoms according to a surgical classification. J Minim Invasive Gynecol 12:106–112
Fedele L, Bianchi S, Zanconato G, Portuese A, Raffaelli R (2001) Use of a levonorgestrel-releasing intrauterine device in the treatment of rectovaginal endometriosis. Fertil Steril 75(3):485–488
Vercellini P, De Giorgi O, Mosconi P, Stellato G, Vicentini S, Crosignani PG (2002) Cyproterone acetate versus a continuous monophasic oral contraceptive in the treatment of recurrent pelvic pain after conservative surgery for symptomatic endometriosis. Fertil Steril 77(1):52–61
Fritzer N, Haas D, Oppelt P, Renner S, Hornung D, Wölfler M, Ulrich U, Fischerlehner G, Sillem M, Hudelist G (2013) More than just bad sex: sexual dysfunction and distress in patients with endometriosis. Eur J Obstet Gynecol Reprod Biol 169(2):392–396
Price DD, McGrath PA, Rafii A, Buckingham B (1983) The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain 17(1):45–56
American Society for Reproductive Medicine (1997) Revised American Society for Reproductive Medicine classification of endometriosis: 1996. Fertil Steril 67:817–821
Setala M, Harkki P, Matomaki J, Makinen J, Kossi J (2012) Sexual functioning, quality of life and pelvic pain 12 months after endometriosis surgery including vaginal resection. Acta Obstet Gynecol Scand 91:692–698
Nnoaham KE, Hummelshoj L, Webster P, d’Hooghe T, de Cicco Nardone F, de Cicco Nardone C, Jenkinson C, Kennedy SH, Zondervan KT, World Endometriosis Research Foundation Global Study of Women’s Health consortium (2011) Impact of endometriosis on quality of life and work productivity: a multicenter study across ten countries. Fertil Steril 96(2):366–373
Arruda MS, Petta CA, Abrão MS, Benetti-Pinto CL (2003) Time elapsed from onset of symptoms to diagnosis of endometriosis in a cohort study of Brazilian women. Hum Reprod 18(4):756–759
Hadfield R, Mardon H, Barlow D, Kennedy S (1996) Delay in the diagnosis of endometriosis: a survey of women from the USA and the UK. Hum Reprod 11(4):878–880
Shifren JL, Johannes CB, Monz BU, Russo PA, Bennett L, Rosen R (2009) Help-seeking behavior of women with self-reported distressing sexual problems. J Women’s Health (Larchmt) 18(4):461–468
Laumann EO, Paik A, Rosen RC (1999) Sexual dysfunction in the United States: prevalence and predictors. JAMA 281(6):537–544
Shrifen JL, Monz BU, Russo PA, Segreti A, Johannes CB (2008) Sexual problems and distress in United States women: prevalence and correlates. Obstet Gynecol 112(5):970–978
Kobayashi H, Yamada Y, Morioka S, Niiro E, Shigemitsu A, Ito F (2014) Mechanisms of pain generation for endometriosis-associated pelvic pain. Arch Gynecol Obstet 289(1):13–21
Augoulea A, Alexandroud A, Creatsa M, Vrachinis N, Lambrinoudaki I (2012) Pathogenesis of endometriosis: the role of genetics, inflammation and oxidative stress. Arch Gynecol Obstet 286(1):99–103
Renner SP, Boosz AS, Burghaus S, Maihöfner C, Beckmann MW, Fasching PA, Jud SM (2012) Visual pain mapping in endometriosis. Arch Gynecol Obstet 286(3):687–693
Pacchiarotti A, Milazzo GN, Biasiotta A, Truini A, Antonini G, Frati P, Gentile V, Caserta D, Moscarini M (2013) Pain in the upper anterior-lateral part of the thigh in women affected by endometriosis: study of sensitive neuropathy. Fertil Steril 100(1):122–126
Moscarini M, Milazzo GN, Assorgi C, Pacchiarotti A, Caserta D (2014) Ovarian stripping versus cystectomy: recurrence of endometriosis and pregnancy rate. Arch Gynecol Obstet 290(1):163–167
Kokcu A (2013) Possible effects of endometriosis-related immune events on reproductive function. Arch Gynecol Obstet 287(6):1225–1233
Elgafor El Sharkwy IA (2013) Combination of non-invasive and semi-invasive tests for diagnosis of minimal to mild endometriosis. Arch Gynecol Obstet 288(4):793–797
Leyendecker G, Bilgicyildirim A, Inacker M, Stalf T, Huppert P, Mall G, Böttcher B, Wildt L (2015) Adenomyosis and endometriosis. Re-visiting their association and further insights into the mechanisms of auto-traumatisation. An MRI study. Arch Gynecol Obstet 291(4):917–932
De Cicco Nardone C, Terranova C, Plotti F, Ricciardi R, Capriglione S, Luvero D, Caserta D, Moscarini M, Benedetti Panici P, Angioli R (2015) The role of ovarian fossa evaluation in patients with ovarian endometriosis. Arch Gynecol Obstet [Epub ahead of print]
Angioni S, Pontis A, Dessole M, Surico D, De Cicco Nardone C, Melis I (2015) Pain control and quality of life after laparoscopic en-block resection of deep infiltrating endometriosis (DIE) vs incomplete surgical treatment with or without GnRHa administration after surgery. Arch Gynecol Obstet 291(2):363–370
Acknowledgments
The authors would like to thank Mr. Lucio Morettini for the statistical interpretation of the data.
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Lukic, A., Di Properzio, M., De Carlo, S. et al. Quality of sex life in endometriosis patients with deep dyspareunia before and after laparoscopic treatment. Arch Gynecol Obstet 293, 583–590 (2016). https://doi.org/10.1007/s00404-015-3832-9
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DOI: https://doi.org/10.1007/s00404-015-3832-9