Discoid excision for colorectal endometriosis associated infertility: A balance between fertility outcomes and complication rates - Sorbonne Université Access content directly
Journal Articles Journal of Gynecology Obstetrics and Human Reproduction Year : 2024

Discoid excision for colorectal endometriosis associated infertility: A balance between fertility outcomes and complication rates

Abstract

Objective: The objective of our study was to study the impact of discoid excision for deep endometriosis (DE) with colorectal involvement on fertility outcomes. Methods: 49 patients with a desire for pregnancy treated with discoid excision for colorectal endometriosis in our endometriosis expert center between January 2015 and August 2020 were selected from our prospectively maintained database. Indications for surgery were either infertility and / or pelvic pain. Postoperative complications were graded according to the Clavien-Dindo classification. Fertility outcomes, both spontaneous and post-ART pregnancies, were analyzed. Results: Among the 49 patients who underwent discoid excision exclusively (no other digestive resection) with a desire to conceive, 25 had a pregnancy after surgery and 24 did not. Double discoid excision was performed in 6.1 % of the cases (3/49). A colpectomy was performed in 12.2 % of the patients (6/49), and a protective stoma in 12.2 % (6/49). Fenestration of endometriomas was performed in 28.6 % of the patients (14/49), and parametrectomy in 40.8 % (20/49). The postoperative complication rate was 24.5 % (12/49) including 10.2 % (5/49) grade I, 12.2 % (6/49) grade II, and 2 % (1/49) grade III. Prior to surgery, 28 (57.1 %) patients had infertility including 13 (52 %) that successfully conceived following surgery and 15 (62.5 %) that remain infertile. Spontaneous pregnancy was achieved in 60 % (15/25) of infertile patients' prior surgery. The live-birth rate in patients conceiving spontaneously was 75 % (12/16). Conclusion: Our results support that discoid excision is safe and associated with good fertility outcomes. Whether first-line surgery using discoid excision is superior to first-line ART remains to be determined.
Fichier principal
Vignette du fichier
Manuscript discoide fertility.pdf (453.76 Ko) Télécharger le fichier
Origin : Files produced by the author(s)

Dates and versions

hal-04539123 , version 1 (09-04-2024)

Identifiers

Cite

Yohann Dabi, Lea Ebanga, Amélia Favier, Kamila Kolanska, Anne Puchar, et al.. Discoid excision for colorectal endometriosis associated infertility: A balance between fertility outcomes and complication rates. Journal of Gynecology Obstetrics and Human Reproduction, 2024, 53 (2), pp.102723. ⟨10.1016/j.jogoh.2024.102723⟩. ⟨hal-04539123⟩
4 View
2 Download

Altmetric

Share

Gmail Facebook X LinkedIn More