title: Radical Surgery for Endometriosis: Analysis of Quality of Life and Surgical Procedure.
abstract: OBJECTIVE
  The main aim of this study is to determine the improvement in quality of life in patients who have undergone radical surgery because of severe endometriosis.
  
  
  METHODS
  This nonrandomized interventional study (quasi experimental) was carried out between January 2009 and September 2014. A total of 46 patients with diagnosis of severe endometriosis were included. Radical surgery, including hysterectomy, was performed. Acting as their own control group, the patients were asked to fill in a validated questionnaire of quality of life [Endometriosis Health Profile-5 (EHP-5)] and a visual analog scale of pain at the moment of the preoperative visit (one month prior to surgery) and six months after the surgery.
  
  
  RESULTS
  Radical surgery for endometriosis was performed in 46 patients at our center over the period of six years. Among the patients, 73.9% of them had undergone previous surgery for endometriosis. In 82.6% of cases, a complete laparoscopic resection was carried out. Gastrointestinal tract resection was performed in 21.7%, and urinary tract resection was necessary in 8.7%. The mean age of the patients was 38.6 years. The rate of complications was 30.4%. Six months after the surgery, all items of the EHP-5 questionnaire had a lower score, which means an improvement in all aspects of quality of life related to endometriosis. The difference obtained between the scores before and after the surgery was statistically significant. The mean visual analog scale score before the surgery was 8.5, whereas it decreased to 1.4 after the surgery (P < 0.001).
  
  
  CONCLUSIONS
  Performing a radical surgery is a difficult decision to make; however, it can provide optimal results in terms of improvement of quality of life and, therefore, should be considered when conservative therapy fails.
authors.affiliation: Endometriosis Unit, Gynaecology Service, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Cristina M
authors.initials: CM
authors.lastname: De la Hera-Lazaro
authors.affiliation: Endometriosis Unit, Gynaecology Service, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Jose L
authors.initials: JL
authors.lastname: Muñoz-González
authors.affiliation: Endometriosis Unit, Gynaecology Service, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Reyes Oliver
authors.initials: RO
authors.lastname: Perez
authors.affiliation: Endometriosis Unit, Gynaecology Service, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Rocío
authors.initials: R
authors.lastname: Vellido-Cotelo
authors.affiliation: Endometriosis Unit, Gynaecology Service, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Díez-Álvarez
authors.affiliation: Endometriosis Unit, Gynaecology Service, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Leticia
authors.initials: L
authors.lastname: Muñoz-Hernando
authors.affiliation: Endometriosis Unit, Gynaecology Service, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Alvarez-Conejo
authors.affiliation: Endometriosis Unit, Gynaecology Service, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Jesús S
authors.initials: JS
authors.lastname: Jiménez-López
keywords: deep endometriosis; quality of life; radical surgery