Symptoms before and after surgical removal of colorectal endometriosis that are assessed by magnetic resonance imaging and rectal endoscopic sonography

Objective: The purpose of this study was to evaluate the impact of colorectal resection for endometriosis on symptoms and quality of life or on potential side effects. Study design: After magnetic resonance imaging and rectal endoscopic sonographic evaluations of symptomatic colorectal endometriosis, 27 consecutive women who underwent colorectal resection were included in this prospective study. They completed symptom questionnaires before and after the procedure. Linear pain scores for several gynecologic and digestive symptoms and impact on quality of life were recorded. Results: The sensitivity and positive predictive value of magnetic resonance imaging and rectal endoscopic sonographic evaluation for the diagnosis of colorectat endometriosis were 92.6% and 100% and 89% and 100%, respectively. Nonmenstrual pelvic pain (P =.001), dysmenorrhea (P < .0001), dyspareunia (P =.0002), and pain on defecation (P < .005) were improved by colorectal resection. No correlation was found between symptom intensity and lesion size, as evaluated by magnetic resonance imaging, rectal endoscopic sonographic evaluation, or histologic examination of the surgical specimen. Respectively, the conditions of 14, 11, 0, and 2 women were cured, improved, unchanged, or worsened. Median overall pre- and postoperative quality-of-life scores were 9 (range, 4-10) and 0 (range, 0-10), respectively (P < .0001). Conclusion: Colorectal resection for endometriosis appears to relieve some symptoms. However, women should be informed that some symptoms may persist and that there is a risk of urinary and digestive side effects. (C) 2004 Elsevier Inc. All rights reserved.