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Excision of Lesions May Improve Sexual Function


 

CHICAGO — Laparoscopic excision of endometriotic lesions of the uterosacral ligament improves not only deep dyspareunia but also the quality of patients' sex life, Dr. Simone Ferrero said at the annual meeting of the AAGL (formerly the American Association of Gynecologic Laparoscopists).

Pain during intercourse affects 60%–79% of women with endometriosis who undergo surgery.

Among women who have deep dyspareunia, those with deep infiltrating endometriosis of the uterosacral ligament have the most severe impairment of their sexual function.

The presence of bilateral lesions on the uterosacral ligament does not influence the severity of symptoms, said Dr. Ferrero of San Martino Hospital and the University of Genoa, Italy.

He presented a prospective study in which 64 women with deep dyspareunia were surveyed before surgical excision of endometriotic lesions and 1 year after surgery using a questionnaire based on the sexual satisfaction subscale of the Derogatis Sexual Functioning Inventory, additional questions regarding the characteristics of dyspareunia, the Global Sexual Satisfaction Index, and a 100-mm visual analog scale to measure the intensity of dyspareunia.

All of the women received 6 months of postoperative treatment with the gonadotropin-releasing hormone analogue, triptorelin.

The main indications for surgery were pain symptoms (29), ovarian cysts (20), and infertility (15).

At 1-year follow-up, 29 of the women had no deep dyspareunia, 25 had decreased intensity (more than a 20-mm change on the visual analog scale), and 10 experienced no change.

One year after surgery patients had had significantly more intercourse per week in the previous 3 months (1.3 vs. 2.3), more satisfying orgasms (2.3 vs. 4.4), were more relaxed and fulfilled after sex (3.2 vs. 4.5), and were less frequently interrupted by pain during intercourse (3.7 vs. 2).

Global Sexual Satisfaction Index scores also significantly improved (P less than or equal to.001).

The surgery didn't significantly change whether the women were “usually satisfied” with their particular partner (5 vs. 5.2).

Women in the study had been with their partners for an average of 11 years; 42 were married, 10 were cohabiting, 6 were engaged, and 6 were single. The average age of the women was 34 years.

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