Korteschiel, L.R. (2012) Functional outcome of urinary tract and defecation symptoms and quality of life after radical excision of deep infiltrating endometriosis of the rectosigmoid and urinary tract. thesis, Medicine.
Full text available on request.Abstract
Introduction and research question: Deep infiltrating endometriosis (DIE) of the rectosigmoid and urinary tract can be treated by radical resection. However, this operation may cause several defecation and urinary tract symptoms. The purpose of this retrospective study is to map the pre- and postoperative complaints and identify the predictors of postoperative complaints. This might lead to improvement of the surgical treatment of DIE and amelioration of patient information. Materials and methods: 109 patients who had surgery between July 2005 and November 2010 were sent a questionnaire, which was used to investigate urinary tract and defecation symptoms, satisfaction rate and some quality of life items. The Wilcoxon signed rank test, the McNemar test, the Mann-Whitney U-test and multivariate linear, logistic and ordinal regression were used. Results: 62% of approached patients returned their questionnaire. All pain scores improved, as well as a lot of other complaints. The median of the satisfaction rate is 8. The number of patients with one or more defecation symptoms decreased, but the presence of defecation symptoms and especially a high frequency of defecation affects the satisfaction rate. The number of patients with one or more urinary tract symptoms remained the same. Some urinary tract symptoms also affect the satisfaction rate. Symptoms that deteriorated are the feeling of incomplete emptying, a high frequency of defecation and the presence of urinary urge or stress incontinence. Multivariate regression analysis revealed a relationship between the satisfaction rate and pain in the abdomen without menstruation, the use of enemas or medication for defecation during menstruation, an altered size of urinary flow and a high frequency of defecation, while the presence of bowel cramps, not daring to defecate because of expected pain and unstoppable urge for defecation affect the quality of life. No pre- or peroperative predictors for postoperative defecation and urinary tract symptoms were found using multivariate regression analysis. A relationship between surgery of the rectosigmoid and the presence of a high frequency of defecation was found. Discussion and conclusion: Laparoscopic radical resection of DIE is an effective treatment of many symptoms. In a subset of patients, defecation and urinary tract disorders that affect the satisfaction rate and quality of life arise. Surgery of the rectosigmoid is related to one of these symptoms. Multivariate regression analysis did not reveal any pre- or peroperative predictors of postoperative complaints. Patients need to be informed about these findings.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Supervised by and Hofker, H.S. Surgeon and Department of Abdominal Surgery and University Medical Centre Groningen |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:54 |
| Last Modified: | 25 Jun 2020 10:54 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1457 |
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