Improved quality of life (EHP-30) in patients with endometriosis after surgical treatment

Nogueira Neto, João; Melo, Vinicius Gonçalves; Lima, Luna Carolina Silva; Costa, Miguel Vinicius Lima Reis; Silva, Leonardo Carvalho; Gomes, Lyvia Maria Rodrigues de Sousa; Freire, Glaúcia Iraúna de Melo; Leal, Plinio da Cunha; Oliveira, Caio Marcio Barros de; Moura, Ed Carlos Rey

doi:10.1590/1806-9282.20230316

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Revista da Associação Médica Brasileira

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Original Article • Rev. Assoc. Med. Bras. 69 (8) • 2023 • https://doi.org/10.1590/1806-9282.20230316 copy

Improved quality of life (EHP-30) in patients with endometriosis after surgical treatment

Authorship SCIMAGO INSTITUTIONS RANKINGS

SUMMARY

OBJECTIVE:

This study aimed to evaluate the quality of life of patients with endometriosis before and after surgical treatment.

METHODS:

An observational, longitudinal, and prospective study was conducted with 102 women with pelvic pain and endometriosis that was unimproved by clinical treatment and indicated for surgical treatment. The patients’ quality of life was assessed using the 30-item Endometriosis Health Profile (EHP-30) questionnaire before and 3 and 6 months after surgery. The statistical tests were analyzed using the Statistical Package for Social Sciences version 17.0, and the Friedman test was used.

RESULTS:

There was a reduction in EHP-30 scores 3 and 6 months after surgery compared to before surgery, as well as 6 months after surgery compared to 3 months after surgery, in the central questionnaire (PART 1) and in Sections A, B, C, E, and F (p<0.0001). For Section D, there was a reduction in scores 6 months after surgery compared to before surgery (p<0.0001).

CONCLUSION:

Surgical treatment of endometriosis improves quality of life in several areas assessed by the EHP-30 questionnaire.

KEYWORDS:
Endometriosis; Surgical procedure; Quality of life

Variables		No. (%)	Standard deviation
All cases		102 (100%)	–
Age		–	35.96±6.309
Marital status
	Single	34 (33.3%)	–
	Married	68 (66.6%)	–
Race
	White	18 (17.6%)
	Brown	70 (68.6%)
	Black	18 (17.6%)
rASRM classification of endometriosis
	Stage I (minimum)	9 (8.8%)
	Stage II (mild)	18 (17.6%)
	Stage III (moderate)	35 (34.3%)
	Stage IV (severe)	40 (39.3%)
Surgeries performed
	Edt alone	21 (20.5%)
	Edt+mio	30 (29.5%)
	Edt+hta	23 (22.6%)
	Edt+hta+rectosig	23 (22.6%)
	Edt+mio+rectosig	5 (4.9%)

EHP-30	Before surgery	3 months after surgery	6 months after surgery	p-value
Part 1	46.67 (29.16–46.67)^a a Significant difference according to Dunn's posttest before surgery and 3 months after surgery; ,^b b significant difference according to Dunn's posttest before surgery and 6 months after surgery;	16.25 (8.33–30)^a a Significant difference according to Dunn's posttest before surgery and 3 months after surgery; ,^c c significant difference according to Dunn's posttest between 3 months after surgery and 6 months after surgery.	7.5 (3.198–15.83)^b b significant difference according to Dunn's posttest before surgery and 6 months after surgery; ,^c c significant difference according to Dunn's posttest between 3 months after surgery and 6 months after surgery.	<0.0001
Section A	35 (10–60)^a a Significant difference according to Dunn's posttest before surgery and 3 months after surgery; ,^b b significant difference according to Dunn's posttest before surgery and 6 months after surgery;	10 (0–25)^a a Significant difference according to Dunn's posttest before surgery and 3 months after surgery; ,^c c significant difference according to Dunn's posttest between 3 months after surgery and 6 months after surgery.	0 (0–10)^b b significant difference according to Dunn's posttest before surgery and 6 months after surgery; ,^c c significant difference according to Dunn's posttest between 3 months after surgery and 6 months after surgery.	<0.0001
Section B	50 (0–62.50)^a a Significant difference according to Dunn's posttest before surgery and 3 months after surgery; ,^b b significant difference according to Dunn's posttest before surgery and 6 months after surgery;	0 (0–25)^a a Significant difference according to Dunn's posttest before surgery and 3 months after surgery; ,^c c significant difference according to Dunn's posttest between 3 months after surgery and 6 months after surgery.	0 (0–12.50)^b b significant difference according to Dunn's posttest before surgery and 6 months after surgery; ,^c c significant difference according to Dunn's posttest between 3 months after surgery and 6 months after surgery.	<0.0001
Section C	50 (20–75)^a a Significant difference according to Dunn's posttest before surgery and 3 months after surgery; ,^b b significant difference according to Dunn's posttest before surgery and 6 months after surgery;	15 (0–50)^a a Significant difference according to Dunn's posttest before surgery and 3 months after surgery; ,^c c significant difference according to Dunn's posttest between 3 months after surgery and 6 months after surgery.	7.5 (0–15)^b b significant difference according to Dunn's posttest before surgery and 6 months after surgery; ,^c c significant difference according to Dunn's posttest between 3 months after surgery and 6 months after surgery.	<0.0001
Section D	0 (0–0)^b b significant difference according to Dunn's posttest before surgery and 6 months after surgery;	0 (0–0)	0 (0–0)^b b significant difference according to Dunn's posttest before surgery and 6 months after surgery;	<0.0001
Section E	41.66 (0–66.66)^a a Significant difference according to Dunn's posttest before surgery and 3 months after surgery; ,^b b significant difference according to Dunn's posttest before surgery and 6 months after surgery;	16.66 (0–25)^a a Significant difference according to Dunn's posttest before surgery and 3 months after surgery; ,^c c significant difference according to Dunn's posttest between 3 months after surgery and 6 months after surgery.	0 (0–8.33)^b b significant difference according to Dunn's posttest before surgery and 6 months after surgery; ,^c c significant difference according to Dunn's posttest between 3 months after surgery and 6 months after surgery.	<0.0001
Section F	50 (25–75)^a a Significant difference according to Dunn's posttest before surgery and 3 months after surgery; ,^b b significant difference according to Dunn's posttest before surgery and 6 months after surgery;	25 (6.25–56.25)^a a Significant difference according to Dunn's posttest before surgery and 3 months after surgery; ,^c c significant difference according to Dunn's posttest between 3 months after surgery and 6 months after surgery.	6.25 (0–25)^b b significant difference according to Dunn's posttest before surgery and 6 months after surgery; ,^c c significant difference according to Dunn's posttest between 3 months after surgery and 6 months after surgery.	<0.0001

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[1] *Corresponding author: j.nogueira.n@uol.com.br