Outcomes of Laparoscopic Surgery of Deep Infiltrating Endometriosis: A Prospective Cohort Study in Yas Infertility Center, Tehran

Abstract

Background: Endometriosis is a prevalent medical condition that significantly affect the quality of life in a substantial proportion of women, affecting their fertility and manifesting with many symptoms like gastrointestinal symptoms. The present study aimed to evaluate the impact of laparoscopic surgery for endometriosis on general and sexual quality of life, and gastrointestinal symptoms in patients diagnosed with deep infiltrating endometriosis (DIE). Materials and Methods: This prospective cohort study was conducted on 129 women diagnosed with DIE-associated infertility and referred to Yas Infertility Center in Tehran , from 2022 to 2023. Demographic data and the presence and severity of gastrointestinal symptoms were recorded. These symptoms were reassessed one month following endometriosis surgery. Participants were also asked to complete the SF-36 Quality of Life Questionnaire and Female Sexual Function Index (FSFI) questionnaires before the surgical procedure and one month later. Data were analyzed using SPSS version 24. Results: This study of 129 patients (mean age 34.82±5.83 years, BMI 25.64±3.77 kg/m²) revealed near-universal ovarian involvement (99.2%) and adhesions (99.2%), primarily affecting rectosigmoid (24.1%) and cervix (29.5%). Pre-intervention, 98.4% reported abdominal pain (47.3% severe), 37.9% bloating, and 24.8% constipation. Post-intervention showed dramatic improvements: pain-free cases rose to 90.7%, bloating reduced to 9.3%, and constipation to 6.2% (all P<0.0001). The FSFI score increased (57.6±28.8 to 65.2±27.4, P<0.0001), and SF-36 pain scores halved (6.8±1.2 to 2.7±0.9, P<0.0001), though vitality and emotional well-being remained unchanged. Surgical complications included hemoglobin drop (17.8%) and intestinal injury (6.2%). Conclusion: The findings of this study indicate that laparoscopic treatment of DIE not only alleviates gastrointestinal symptoms but also significantly enhances the quality of life and sexual function in affected women.