SF-36 preoperative interest of predicting improvement of quality of life after laparoscopic management of minimal endometriosis

Abstract

The purpose of the study: To study preoperative thresholds of the SF-36 components above which we can predict a high risk of failure in order to improve the quality of life after surgery for patients with minimal endometriosis.

Material and methods: Design: prospective and multicenter observational study between February 2004 and 2011.

Patients: 167 patients with operated minimal endometriosis.

Setting: for the Physical Component Summary (PCS) or the Mental Component Summary (MCS) subscales of the SF-36 questionnaire, an improvement defined by an increase of 5 points.

Intervention: evaluation by the SF-36 questionnaire the week before and one year after surgery.

Measurement and main results: Success of surgery measured by an improvement in both components. We found significantly different initial variables between patients with improvement and those without: initial MCS score (P=0.0003), initial PCS score (P<0.0001) and dyspareunia (P=0.004). Multivariate analysis revealed only two significant variables. Initial MCS higher than 40 (OR=4.6) and initial PCS higher than 50 (OR=10.6) are risk factors for failure of improvement after surgery.

Conclusion: Surgery is seldom a good treatment for improving QOL in minimal endometriosis. We set two thresholds for SF-36, 50 for PCS and 40 for MCS: above there is a very high risk of failure (86% of failure in our population). Under, the risk of failure remains high (54.3%).

Canadian task force classification of study design: Evidence obtained from well-designed cohort or case-control studies, preferably from more than one center or research group.

Keywords: Endometriosis; Quality of life; SF-36.