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Improved pain and quality of life after complete pelvic peritonectomy

      Objectives

      Surgical management of endometriosis reduces pain and improves quality of life, though debate continues regarding optimal technique. We evaluated the impact of complete pelvic peritonectomy (excision of anterior and posterior cul-de-sac peritoneum) for women with chronic pelvic pain (CPP).

      Materials and Methods

      This was a prospective cohort study of women who underwent complete pelvic peritonectomy from 11/2019 - 11/2020 at a tertiary academic center. Women completed the Endometriosis Health Profile-30 (EHP-30) and Visual Analog Scale (VAS) pain scores assessment preoperatively, 6-weeks postoperatively, and 6-months postoperatively. One-way repeated measures ANOVA compared scores at each interval. Scores for women with confirmed endometriosis were compared to those without endometriosis.

      Results

      31 of 44 enrolled women completed the 6-month assessments (70.5% response). American Society of Reproductive Medicine stage ranged from 0 (n=6, 19.4%), 1 (n=14, 45.2%), or 2 (n=11, 35.5%). 22 women had histologic evidence of endometriosis (70.9%).
      Mean EHP-30 scores significantly decreased preoperatively to 6-months postoperatively (65 vs. 28.5, p<0.001) with improvement in all subscales. VAS pain scores improved in most domains at 6 months (Table 1). With the exception of dysmenorrhea, women with and without endometriosis did not report different scores preoperatively. 6-month EHP-30 scores improved and did not differ between groups, though dyschezia and nonmenstrual pain improved more for women with endometriosis (Table 2).

      Conclusion