Questionnaire-based evaluation of sexual life after laparoscopic surgery for endometriosis: a systematic review of prospective studies.
- Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
- Department of Obstetrics & Gynecology, Skåne University Hospital, Malmö-Lund, Sweden.
- Sexological Clinic, Psychiatric Center Copenhagen, Copenhagen, Denmark.
- Department of Obstetrics & Gynecology, Odense University Hospital, Odense, Denmark.
Endometriosis is a benign disease that affects women of reproductive age. Laparoscopic excision of endometriotic implants is considered one of the most effective therapeutic options. The disease and its treatment can have a major impact on psychosexual well-being but this is often overlooked as most studies focus on pain instead of sexuality in a holistic approach. The aim of this study was to review the current literature regarding the effect of laparoscopic surgery for endometriosis on quality of sexual life (QoSL).
MATERIAL AND METHODS:
Following the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" guidelines we conducted a systematic review that involved searching PubMed and Embase databases for prospective studies evaluating the effect of laparoscopic surgery for endometriosis on QoSL, using validated questionnaires.
Of 357 papers, 17 were selected for full text evaluation. Twelve studies using seven different questionnaires fulfilled the inclusion criteria. All studies reported improvements in QoSL following laparoscopic surgery for endometriosis. A meta-analysis could not be performed due to substantial heterogeneity among the included studies arising from differences in questionnaires, follow-up duration, stages of endometriosis, use of hormonal treatment, and missing data.
Laparoscopic excision of endometriosis can improve QoSL. However, there is a need for randomized controlled trials based on a new validated questionnaire regarding specifically QoSL in association with endometriosis. As sexual functioning is a complex phenomenon driven by multiple physical, psychological and social factors, QoSL should be holistically evaluated by a team of different healthcare providers, implementing treatment programs that are individualized to each woman.
© 2018 Nordic Federation of Societies of Obstetrics and Gynecology.
Endometriosis; laparoscopy; questionnaire; sexual function; systematic review
Dr. K's Comment:
This study looked at OTHER studies to consider whether excision of endo improved the quality of the patient's sexual life. The conclusion? Yes, excising endo improves quality of sexual life. Not news to us, but good to see attention being paid.