title: Is nerve-sparing surgery suitable for deeply infiltrating endometriosis?
abstract: OBJECTIVE
  To investigate the efficacy of nerve-sparing surgery for deeply infiltrating endometriosis (DIE) and the bladder and sexual dysfunction that follow this procedure.
  
  
  METHODS
  A total of 108 women with DIE underwent conventional surgery (group A, n=63) and nerve-sparing surgery (group B, n=45). Three validated interview-based questionnaires - the visual analogue scale (VAS), the international prostate score symptom (IPSS), and the female sexual function index (FSFI) - were used to evaluate the efficacy and associated complications.
  
  
  RESULTS
  The VAS scores significantly decreased in both groups A and B after surgery, although two patients (4.4%) in group B had no improvement in their pain symptoms. The total FSFI and each domain scores significantly increased in the two groups after surgery except for satisfaction at the 24-month follow up in group A. Nine patients (15.9%) in group A required self-catheterization postoperatively. Based on the IPSS scores, a significant alteration in voiding symptoms in group A was observed at 6 months but not at 12 months or 24 months after surgery. In group B, however, no significant difference or self-catheterization requirement was observed after surgery.
  
  
  CONCLUSIONS
  Reduced bladder and sexual dysfunction, but with a risk of absence of pain relief, suggests that the pros and cons of nerve-sparing surgery for DIE should carefully be evaluated before operation.
authors.affiliation: Jiaxing Maternity and Child Health Care Hospital, Jiaxing, Zhejiang 314050, PR China.
authors.forename: Xuan
authors.initials: X
authors.lastname: Che
authors.affiliation: Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310006, PR China.
authors.forename: Xiufeng
authors.initials: X
authors.lastname: Huang
authors.affiliation: Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310006, PR China.
authors.forename: Jing
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310006, PR China.
authors.forename: Hong
authors.initials: H
authors.lastname: Xu
authors.affiliation: Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310006, PR China. Electronic address: zxm20130729@163.com.
authors.forename: Xinmei
authors.initials: X
authors.lastname: Zhang
mesh_terms: D000328:Adult; D004715:Endometriosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D059348:Peripheral Nerve Injuries / Q000517:prevention & control*; D012735:Sexual Dysfunction, Physiological / Q000209:etiology*; D014555:Urination Disorders / Q000209:etiology*
keywords: Deeply infiltrating endometriosis; Female sexual function index; International prostate score symptom; Nerve-sparing surgery; Visual analogue scale