Does minimally invasive surgery for endometriosis improve pelvic symptoms and quality of life?
OBJECTIVE
Endometriosis is a common gynaecological disorder estimated to affect over 70 million women worldwide. In this review we aim to give an overview of postoperative symptoms and look at factors influencing therapeutic choices and surgical techniques.


RESULTS
A wide range of physical and psychological factors contribute to the symptoms of disease. Patients suffer from impaired quality of life, depression, anxiety and chronic and acute pain. Validated questionnaires have been used to assess patient response. Surgical excision of endometriosis improves dyspareunia and the quality of sex life of patients. It is superior in outcomes to medical therapy in achieving increased pregnancy rates. Catastrophizing and biopsychosocial variables are implicated in the severity of pain experienced in patients with endometriosis. Patients with endometriosis score lower on quality of life assessments and the addition of psychosomatic therapy to medical treatments has shown to improve the emotional status of patients with improved treatment outcomes.


CONCLUSIONS
Despite its prevalence, there is no optimal treatment for endometriosis; recurrence of disease is a common problem. Laparoscopic surgery compared with medical therapies shows improved patient satisfaction outcomes in general health, quality of life and emotional wellbeing. Management of this varied aetiology improves in the context of a multidisciplinary team.
Centre for Reproductive Medicine, St. Bartholomew's Hospital London, UK. christine.deguara@bartsandthelondon.nhs.uk
Christine S
CS
Deguara
Litha
L
Pepas
Colin
C
Davis
D000328:Adult; D001007:Anxiety / Q000209:etiology / Q000517:prevention & control*; D003075:Coitus / Q000523:psychology; D003863:Depression / Q000209:etiology / Q000517:prevention & control*; D004414:Dyspareunia / Q000209:etiology / Q000517:prevention & control*; D004715:Endometriosis / Q000150:complications* / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000517:prevention & control*; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D017060:Patient Satisfaction; D017699:Pelvic Pain / Q000209:etiology* / Q000517:prevention & control / Q000523:psychology; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult