STUDY QUESTION What is the relationship between sexual function, health-related quality of life (HRQoL), and laparoscopic surgery in individuals living with endometriosis? SUMMARY ANSWER A higher number of laparoscopic surgeries is significantly associated with poorer HRQoL and greater levels of sexual dysfunction in individuals with endometriosis. WHAT IS KNOWN ALREADY Prior research indicates that endometriosis is associated with lowered HRQoL and sexual function and that these outcomes are influenced by endometriosis-related symptom profiles, medical, and surgical management. A limited number of studies have examined changes in sexual function in individuals with endometriosis following laparoscopic surgery or following repeated surgeries. STUDY DESIGN, SIZE, DURATION A cross-sectional community-based online survey was used to examine the relationships between sexual function, HRQoL, and laparoscopic surgery (n = 210). PARTICIPANTS/MATERIALS, SETTING, METHODS Individuals with a self-reported diagnosis of endometriosis were recruited via online advertising through social media and gynaecology clinics. Endometriosis-specific data (e.g. diagnostic delay, symptom experience) was collected in addition to engagement with laparoscopic surgery, level of HRQoL (EuroQol-5 Dimension: EQ-5D-5L), and sexual function (Female Sexual Function Index: FSFI). Bivariate correlational analyses and hierarchical multiple regression were used to determine the associations between the variables of interest. MAIN RESULTS AND THE ROLE OF CHANCE Individuals with endometriosis have substantially poorer HRQoL in comparison to Australian normative samples, with greater levels of endometriosis-related symptom burden, distress, and pain significantly associated with lower levels of HRQoL. The mean FSFI score was suggestive of clinically significant female sexual dysfunction, with the lowest level of function noted in the domain of sexual pain and the highest level of function noted in the sexual satisfaction domain. A greater number of laparoscopic surgeries was significantly associated with poorer overall HRQoL and greater levels of sexual dysfunction. LIMITATIONS, REASONS FOR CAUTION The cross-sectional nature of the data precludes direct findings of causality and further longitudinal research is recommended. The information pertaining to engagement in laparoscopic surgery was self-report in nature and was not medically verified. WIDER IMPLICATIONS OF THE FINDINGS The study’s findings highlight the pervasive impact of endometriosis on all domains of living, emphasizing the need to extend treatment planning beyond that of physical pain management alone. Early referral for assessment and management of sexual wellbeing is recommended prior to, and post-surgical intervention, with a focus on maintaining post-surgical changes, potentially reducing the need for multiple surgeries. STUDY FUNDING, COMPETING INTEREST(S) The study was not associated with research funding. Author CN reports grant funding from the Australian Government and Medical Research Future Fund (MRFF) and was a previous employee of CSL Vifor (formerly Vifor Pharma Pty Ltd). TRIAL REGISTRATION NUMBER N/A.

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子宫内膜异位症患者腹腔镜手术后性功能和健康相关生活质量的评估

研究问题 子宫内膜异位症患者的性功能、健康相关生活质量 (HRQoL) 和腹腔镜手术之间有何关系？摘要答案 子宫内膜异位症患者腹腔镜手术次数增多与 HRQoL 较差和性功能障碍程度升高显着相关。已知信息 先前的研究表明，子宫内膜异位症与 HRQoL 和性功能降低有关，并且这些结果受到子宫内膜异位症相关症状、医疗和手术治疗的影响。有限的研究检查了子宫内膜异位症患者在腹腔镜手术或重复手术后性功能的变化。研究设计、规模、持续时间 采用基于社区的横断面在线调查来检查性功能、HRQoL 和腹腔镜手术之间的关系 (n = 210)。参与者/材料、环境、方法通过社交媒体和妇科诊所的在线广告招募自我报告诊断为子宫内膜异位症的个人。除了参与腹腔镜手术、HRQoL 水平（EuroQol-5 维度：EQ-5D-5L）和性功能（女性性功能指数：FSFI）之外，还收集子宫内膜异位症特异性数据（例如诊断延迟、症状经历）。使用双变量相关分析和层次多元回归来确定感兴趣变量之间的关联。主要结果和机会的作用 与澳大利亚正常样本相比，子宫内膜异位症患者的 HRQoL 明显较差，子宫内膜异位症相关症状负担、痛苦和疼痛水平较高，与 HRQoL 水平较低显着相关。平均 FSFI 评分提示临床上显着的女性性功能障碍，其中性疼痛领域的功能水平最低，性满意度领域的功能水平最高。腹腔镜手术次数增多与整体 HRQoL 较差和性功能障碍程度升高显着相关。局限性和注意理由数据的横截面性质排除了因果关系的直接发现，建议进行进一步的纵向研究。有关参与腹腔镜手术的信息本质上是自我报告，未经医学验证。研究结果的更广泛影响该研究的结果强调了子宫内膜异位症对生活各个领域的普遍影响，强调需要将治疗计划扩展到单纯的身体疼痛管理之外。建议在手术干预之前和术后尽早转诊进行性健康评估和管理，重点是维持术后变化，从而可能减少多次手术的需要。研究经费、竞争利益 该研究与研究经费无关。作者 CN 报告获得澳大利亚政府和医学研究未来基金 (MRFF) 的资助，并且是 CSL Vifor（前身为 Vifor Pharma Pty Ltd）的前雇员。试用注册号 不适用。