Female Sexual Function in Women with Suspected Deep Infiltrating Endometriosis

Abstract

Objective To evaluate the quality of the sexual function of women with suspected deep infiltrating endometriosis.

Methods A cross-sectional, observational and prospective study was conducted between May 2015 and August 2016, in which 67 patients with deep infiltrating endometriosis, suspected or diagnosed, were assessed for epidemiological and clinical characteristics, such as pain level through a visual analog scale (VAS), features of deep infiltrating endometriosis lesions and score on the Female Sexual Function Index (FSFI) before the onset of treatment. The statistical analysis was performed using the software STATA version 12.0 (StataCorp LLC, College Station, TX, USA) to compare the variables through multiple regression analysis.

Results The average age of the patients was 39.2 years old; most patients were symptomatic (92.5%); and the predominant location of the deep infiltrating lesions was on the rectosigmoid colon (50%), closely followed by the retrocervical region (48.3%). The median overall score on the FSFI was 23.4; in 67.2% of the cases the score was ≤ 26.5 (cutoff point for sexual dysfunction). Deep dyspareunia (p = 0.000, confidence interval [CI]: 0.64–0.83) and rectosigmoid endometriosis lesions (p = 0.008, CI: 0.72–0.95) showed significant correlation with lower FSFI scores, adjusted by bladder lesion, patients' age and size of lesions. Deep dyspareunia (p = 0.003, CI: 0.49–0.86) also exhibited significant correlation with FSFI pain domain, adjusted by cyclic bowel pain, vaginal lesion and use of gonadotropin-releasing hormone (GnRH) analog. These results reflect the influence of deep dyspareunia on the sexual dysfunction of the analyzed population.

Conclusion Most patients exhibited sexual dysfunction, and deep dyspareunia was the pelvic painful symptom that showed correlation with sexual dysfunction.

Resumo

Objetivo Avaliar a qualidade da função sexual em pacientes com suspeita de endometriose profunda infiltrativa.

Métodos Foi realizado um estudo observacional transversal prospectivo entre maio de 2015 e agosto de 2016, no qual foram analisados os dados clínicos e epidemiológicos de 67 pacientes com endometriose profunda presuntiva ou diagnosticada, níveis de dor através de escala visual analógica (EVA) e Índice de Função Sexual Feminina (questionário IFSF) antes do início do tratamento. A análise estatística foi realizada utilizando o programa estatístico STATA, na versão 12.0 (StataCorp LLC, College Station, TX, USA), para comparar as variáveis por meio de regressão múltipla.

Resultados A idade média foi de 39,2 anos; houve predominância de mulheres sintomáticas (92,5%) e da localização de lesões de endometriose profunda em retossigmoide (50%) seguida pela topografia retrocervical (48,3%). A pontuação total no IFSF mostrou uma mediana de 23,4, e em 67,2% das mulheres a pontuação foi ≤ 26,55 (cut-off que indica disfunção sexual). Dispareunia (p = 0.000, intervalo de confiança [IC]: 0.64–0.83) e lesão endometriótica em retossigmoide (p = 0.008, IC: 0.72–0.95) exibiram uma relação estatisticamente significante com valores baixos de pontuação no IFSF, ajustados por lesão em bexiga, idade da paciente e tamanho da lesão. A dispareunia de profundidade também mostrou correlação significante com o domínio dor do IFSF ajustado por dor cíclica intestinal, lesão vaginal e uso de análogo de hormônio liberador de gonadotrofina (GnRH). Os resultados refletem a influência da dispareunia de profundidade na disfunção sexual da população do estudo.

Conclusão A maioria das pacientes apresentava disfunção sexual e o sintoma mais relacionado a esta disfunção foi dispareunia de profundidade.

Keywords

endometriosis - sexuality - deeply infiltrating endometriosis

Palavras-chave

endometriose - sexualidade - endometriose profunda infiltrativa

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