Quality of Life Assessment Using EuroQOL EQ-5D Questionnaire in Patients with Deep Infiltrating Endometriosis: The Relation with Symptoms and Locations

The objective of this study was to evaluate the quality of life (QOL) of patients with deep infiltrating endometriosis (DIE) using EuroQOL (EQ-5D) and its correlation with symptoms and locations of endometriotic lesions. One hundred and fifty-nine patients referred for DIE from January 2011 to April 2011 were prospectively invited to complete questionnaires evaluating symptoms associated with endometriosis as well as the EQ-5D questionnaire and health state. Patients also had locations of DIE evaluated by clinical examination and magnetic resonance imaging (MRI). All 159 patients completed the questionnaires. Item response rate was 91.1%. The most intense symptoms were dysmenorrhea (7.1/10), painful defecation (6.3/10), and fatigue (6.0/10). Mean (SD) scores were 77 (14) for the EQ-5D questionnaire and 63.4 (21) for the health state. A relation was observed between the EQ-5D questionnaire and the presence of dysmenorrhea, dyspareunia, cyclic pelvic pain, painful defecation, and diarrhea or constipation. Vaginal and rectal infiltrations were significantly associated with altered EQ-5D and health state scores. The EQ-5D questionnaire is easy to complete and well related to symptoms of DIE. Rectal and vaginal infiltrations were found to be determinant factors of altered QOL by the EQ-5D questionnaire and health state. 1. Introduction Endometriosis is a benign but potentially debilitating gynecologic disorder affecting 10% to 15% of patients during their reproductive life [1]. It is a well-known cause of chronic pelvic pain, dysmenorrhea, and dyspareunia affecting quality of life (QOL) [2–4]. There are three types of endometriosis defined by the presence of endometrial glands and stroma outside the uterus: the peritoneal, the ovarian, or the deep infiltrating endometriosis (DIE); this latter type is characterized by involvement of organs and pelvic anatomic structures by endometriotic lesions. Specific multidimensional questionnaires to evaluate QOL in patients with endometriosis have been developed—by Bodner et al. in 1997 [2], Colwell et al. in 1998 [3], and Jones et al. in 2001 [4]—but have only been validated in English. Nonspecific multidimensional QOL questionnaires such as the short form health survey SF-36 have also been developed and validated in various languages allowing comparison between countries [5, 6]. Despite the absence of specificity for the population of patients with endometriosis, the SF-36 questionnaire has been demonstrated to be a useful tool to select patients with colorectal endometriosis for surgery and to evaluate long-term