Deep dyspareunia and sex life after laparoscopic excision of endometriosis.

BACKGROUND: Among subjects with endometriosis and deep dyspareunia (DD), those with endometriosis of the uterosacral ligament (USLE) have the most severe impairment of sexual function. This study examines the effect of laparoscopic excision of endometriosis on DD and quality of sex life. METHODS: This observational cohort prospective study included 68 women with endometriosis suffering DD (intensity of pain > or = 6 on a 10-cm visual analogue scale). Patients underwent laparoscopic full excision of endometriosis. Following surgery, they were asked to use nonhormonal contraception devices. Before surgery, at 6- and at 12-month follow-up, patients answered a self-administered questionnaire based on the Sexual Satisfaction Subscale of the Derogatis Sexual Functioning Inventory. Patients were also asked to rate their overall level of sexual satisfaction on a 9-point scale (Global Sexual Satisfaction Index, GSSI). RESULTS: Before surgery, the mean intensity of DD was higher in subjects with USLE than in women without this type of lesion (p = 0.010). At 6- and 12-month follow-up, women with and without USLE had significant improvement in DD. Subjects with USLE reported increased variety in sex life, increased frequency of intercourse, more satisfying orgasms with sex, relaxing more easily during sex and being more relaxed and fulfilled after sex. Similar improvements were observed among women without USLE; however, for some variables statistical significance was not reached. Significant improvements in the GSSI were observed at 6-and 12-month follow-up both in women with and without USLE. CONCLUSIONS: Surgical excision of endometriosis improves not only DD but also the quality of sex life.