Fertility after bowel resection for endometriosis.
OBJECTIVE
To determine the pregnancy rate after bowel resection for rectosigmoid endometriosis.


METHODS
Prospective cohort study.


METHODS
University hospital.


METHODS
Forty-six symptomatic women with bowel endometriosis requiring colorectal resection.


METHODS
Bowel resection by either laparoscopy or laparotomy.


METHODS
Pregnancy rate after surgery.


RESULTS
The pregnancy rate was higher in women who underwent bowel resection by laparoscopy (57.6%) than in those who underwent laparotomy (23.1%). No significant difference was observed in pregnancy rate and mode of conception between women with different fertility status before bowel resection. Women who conceived were significantly younger than those who did not conceive; only 26.7% of women aged > or =35 years conceived after bowel resection. Uterine adenomyosis was more frequently present in women who did not conceive than in those who conceived. Infertile women who conceived had a shorter length of infertility before surgery than those who did not conceive.


CONCLUSIONS
Laparoscopic colorectal resection is less likely to impact negatively on fertility than the laparotomy approach. Previous laparotomies, age > or =35 years, uterine adenomyosis, and longer duration of infertility before surgery are associated with decreased pregnancy rate.
Ferrero
Simone
S
Department of Obstetrics and Gynaecology, San Martino Hospital and University of Genoa, Largo R. Benzi 1, Genoa, Italy. dr@simoneferrero.com
Anserini
Paola
P
Abbamonte
Luiza Helena
LH
Ragni
Nicola
N
Camerini
Giovanni
G
Remorgida
Valentino
V
D000328:Adult; D004715:Endometriosis / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005298:Fertility / Q000502:physiology*; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D011183:Postoperative Complications / Q000453:epidemiology; D011247:Pregnancy; D018873:Pregnancy Rate; D012002:Rectal Diseases / Q000209:etiology / Q000601:surgery*; D012810:Sigmoid Diseases / Q000209:etiology / Q000601:surgery*