Avaliação de dor pélvica em pacientes submetidas a tratamento cirúrgico de endometriose

Abstract

To determine changes in the pattern of pelvic pain in patients undergoing surgical procedure with excision and/or ablation of endometriotic lesions, at any stage of the disease. Method: This is a retrospective cohort study carried out from August to October 2021, in patients with pelvic pain undergoing surgical procedure for the treatment of endometriosis between January 2016 and January 2019 in the Hospital's Gynecology and Obstetrics sectors São Vicente de Paulo and Hospital de Clínicas, both located in the city of Passo Fundo, state of Rio Grande do Sul. For the selection of medical records, ICD-10 N80, N80.1 and N80.9 were used. Patients who underwent other treatments and did not progress to surgery were excluded. Sociodemographic, clinical and health variables and pre and postoperative pain symptoms characterization were collected and described as absolute and relative frequencies. Results: At the end of the study, 161 eligible patients were identified, of which 80 were contacted for prospective data collection. A pattern of white women older than 35 years, with a partner, high level of education and paid profession was observed. There was a predominance of normal Body Mass Index, menarche before 14 years of age, nulligest, without previous procedure for the treatment of endometriosis, using oral contraceptives before surgery, with chief complaint of pelvic pain and videolaparoscopic treatment procedure for the lesions combined with rectosigmoidectomy . Pain symptoms measured preoperatively were 66.2% for severe pelvic pain, 46.3% for moderate dysmenorrhea, and 46.3% for severe dysmenorrhea. Other symptoms reported were dyschezia, dysuria and dyspareunia. Regarding postoperative pain, improvement in pain was reported in 98.8% of patients, and in 83.8% mild pelvic pain, and of these 55.0% reported zero pain. Conclusion: The surgical procedure, although invasive, seems to be the best therapeutic option currently for changing the pattern of pelvic pain, as it has considerably reduced the symptoms of endometriosis in the most varied clinical presentations of the disease.