Impact of Bowel Endometriosis Surgery on Bowel and Bladder Function,Pain Symptoms and Quality of Life

Abstract

Purpose

To evaluate the impact of bowel endometriosis surgery on obstructive defecation syndrome symptoms, bladder dysfunction, pain symptoms and quality of life (QOL).

Methods

This was a retrospective cohort study of patients who underwent surgery for endometriosis where bowel was involved between 2005 and 2013. Patients were grouped according to extent of bowel endometriosis treatment: Group 1 - no treatment of bowel endometriosis, Group 2 - “shaving” of endometriosis, Group 3 - wedge resection, or Group 4 - segmental bowel resection. Data were collected via chart review and a mail-out survey consisting of six validated questionnaires designed to evaluate the study aims.

Results

Of 337 eligible patients, completed survey responses were returned by 99.

There were 22 patients in Group 1, 61 in Group 2, 5 in Group 3 and 11 in Group 4. Patient demographic data were similar across the groups. There was no difference in disease severity between Groups 1-4, nor between respondents and non-respondents. Patients in Group 4 were more likely to have open surgery (p<0.001) and to have a stoma placed (p = 0.001). Patients in Group 3 were more likely to have dysmenorrhoea post-operatively (p = 0.02). Otherwise, bowel and bladder symptoms, pain, and health status were comparable between the groups, with a low incidence of bladder symptoms, generally low pain scores, and high QOL for all patients.

Conclusions

Deciding the extent of surgical aggressiveness based on symptom severity has resulted in similar long-term post-operative bowel and bladder symptoms, pain scores, quality of life and overall health across the groups.