Caspian Journal of Internal Medicine 2023 (Spring); 14(2): 267-355
DOI: 10.22088/cjim.14.2.267
Original Article
© The Author(s) Publisher: Babol University of Medical Sciences
Abolfazl Mehdizadehkashi (MD)
1
Shahla Chaichian (MD)
1*
Samaneh Rokhgireh (MD)
1
Kobra Tahermanesh (MD)
1
Shahla Mirgaloybayat (MD)
1
Reza Saadat Mostafavi (MD)
2
Sepideh Khodaverdi (MD)
1
Marziyeh Ajdary (MD)
1
Mahin Ahmadi Pishkuhi (MD)
3
1. Endometriosis Research Center,
Iran University of Medical
Sciences, Tehran, Iran
2. Department of Radiology,
Rasool Hospital, Tehran, Iran
3. Pars Advanced and Minimally
Invasive Medical Manners
Research Center, Pars Hospital,
Tehran, Iran
* Correspondence:
Shahla Chaichian, Endometriosis
Research Center, Iran University of
Medical Sciences, Tehran, Iran
E-mail: shchaichian@gmail.com
Tel: +98 2188952035
Received: 6 Dec 2021
Revised: 15 March 2022
Accepted: 6 June 2022
Does laparoscopic treatment of deep endometriosis improve sexual
dysfunction
Abstract
Background: Endometriosis is one of the common gynecological problems during the
reproductive years, affecting the quality of life, fertility, and sexual function of women. It is
known that sexual dysfunction and quality of life are interrelated. Therefore, this study
aimed to evaluate the effect of resection of endometriosis lesions via laparoscopic surgery
on the improvement of sexual dysfunction in women with endometriosis.
Methods: This clinical trial was performed on 30 patients with endometriosis. The Female
Sexual Function Index, Endometriosis Health Profile-30, and Visual Analog Scale were
completed for the patients before laparoscopic surgery and three, six, and 12 months after
surgery. The results were examined and compared before and after the intervention using
the ANOVA test.
Results: The present results showed that the mean pain score of the patients (dysmenorrhea,
dyspareunia, and pelvic pain) was significant after laparoscopic surgery (P<0.005). The
female sexual function improved after laparoscopic surgery compared to the preoperative
phase, and changes in the domains of psychological stimulation, humidity, and sexual
orgasm were significant (P<0.005). Moreover, the female quality of life scores increased in
all dimensions compared to the preoperative phase, although these improvements were not
statistically significant.
Conclusion: The present results revealed that laparoscopic surgery is an effective treatment,
leading to a considerable improvement in female sexual function.
Keywords: Endometriosis; Laparoscopy; Sexual dysfunction
Citation:
Mehdizadehkashi A, Chaichian Sh, Rokhgireh S, et al. Does laparoscopic Treatment of Deep
Endometriosis Improve Sexual dysfunction? Caspian J Intern Med 2023; 14(1): 267-355.
Endometriosis is a disease characterized by the presence of endometrial glands and
stroma outside the uterine cavity (1). This disease is one of the common gynecological
problems during the reproductive years (2), affecting women’s quality of life and fertility
(3). About 10% of women of childbearing age suffer from pelvic pain and infertility due to
endometriosis (4). Endometriosis affects women of all social and racial classes throughout
the reproductive period (from the onset of menstruation until menopause). Laparoscopy is
one of the available treatments for endometriosis, in which a telescope-like instrument,
called a laparoscope, is inserted through an abdominal incision to observe the reproductive
organs. Laparoscopy can be performed to identify various conditions, such as tubal damage,
endometriosis, pelvic adhesion, and tuberculosis, which can cause infertility. The growing
tendency toward the use of minimally invasive gynecological surgeries has increased the
number of patients undergoing laparoscopy. Besides incisional pain, laparoscopic pain has
been attributed to peritoneal inflammation, pneumoperitoneum, and pelvic or abdominal
rupture. Peritoneal manipulation leads to visceral stimulation and transmission of messages
through the enteric nervous network. Pain may be slightly diffuse, localized, or recurrent.
Visceral pain following laparoscopic surgery can be as severe as incisional pain due to gas
murmurs and manipulation of abdominal structures.