As repercussõesdo tratamento cirúrgico laparoscópico das mulheres com endometriose profunda na qualidade de vida, na depressão e na função sexual

Abstract

Endometriosis is defined by the presence and growth of endometrial tissue outside the uterine cavity, whos e prevalence is 10 to 15% of women in the reproductive phase. Symptoms of endometriosis can often affect the psychological and social functioning of patients, so it is considered a disabling condition that can significantly compromise quality of life, soci al relationships, sexuality and mental health. The main objective of this article is to evaluate the impact of laparoscopic surgery with preservation of fertility for the treatment of deep endometriosis in the general quality of life, depression, sexual fu nction and multidimensional pain scale, as well as to try to establish correlations between these items that impact greatly the well being of women with endometriosis. METHODS: A prospective, hospital based cohort study that evaluated 66 women who underwen t surgical treatment for deep endometriosis at Assis Chateaubriand Maternity School from March 2016 to July 2018. The general quality of life questionnaire (SF 36); the Beck Depression Inventory (IDB), the Sexual Function Questionnaire (FSFI), and the McG ill Multidimensional Pain Scale. After 6 months of surgery, in the outpatient return, 35 patients answered again the questionnaires and the scale mentioned above. Results: when compared before and after surgery, the patients had improvement in the areas of SF36, except Emotional Aspect and Mental Health. They also improved IDB and overall FSFI scores, in addition to the McGill Multidimensional Pain Scale, but there was no significant improvement in lubrication, orgasm and satisfaction, nor in McGill's evalu ative cognitive aspect. There was a negative correlation both before and after the IDB surgery with all SF36 domains. The same was not shown for sexual function, which did not have a significant correlation with either the majority of the SF 36 domains or the BDI and the McGill scale. There was an improvement in the FSFI overall score, but there was no increase in the cut off point 26 considered in the literature as a lower chance of sexual dysfunction. Conclusion: It is concluded that laparoscopic surgery for the treatment of deep endometriosis improves overall quality of life in all SF 36 domains, except for Mental Health and Emotional Aspect, which decreases the risk of depression, which improves the FSFI total score and in the areas of Desire, Excitement and Pain and that diminishes pain in almost all aspects.