[Assessment of the urinary side effects after surgery for deep pelvic endometriosis].
OBJECTIVE
To evaluate the urinary side effects after laparoscopic surgery for deep endometriosis.


METHODS
Longitudinal study including 86 patients operated for deep pelvic endometriosis : 58 (68%) with colorectal endometriosis, 21 (24%) with utero-sacral ligament endometriosis and 7 (8%) with recto-vaginal septum endometriosis. Assessment of the urinary side effects was permormed using the Bristole Female Lower Urinary Tract Symptom questionnaire.


RESULTS
On postsurgical follow-up, almost all patients described: hesistancy (p = 0.02), strain to start (p = 0.04), stopping flow (p = 0.01), incomplete emptying (p = 0.008) and reduce stream (p=0.02). Only patients who had resection of both utero-sacral ligaments had significative postsurgical urinary dysfunction with stopping flow (p = 0.02) and incomplete emptying (p = 0.004). Patients with colorectal resection had also significative postsurgical urinary dysfunction with hesitancy (p = 0.02), strain to start (p = 0.03), stopping flow (p = 0.007) and incomplete emptying (p = 0.004). In patients with rectal resection, urinary dysfunctions are raised when rectal resection is associated to resection of both utero-sacral ligaments.


CONCLUSIONS
Postoperatively, urinary side effects occurred only in patients with segmental colorectal endometriosis resection associated with bilateral utero-sacral ligament resection. Sparing nerve surgery of the pelvic nerves, can reduce these urinary side effects.
Service de Gynécologie Obstétrique, Hôpital Tenon AP-HP, 4, rue de la Chine, 75020 Paris, et Université Pierre et Marie Curie, Paris VI, France. gil.dubernard@tnn.aphp.fr
G
G
Dubernard
R
R
Rouzier
M
M
Piketty
M
M
Bazot
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E
Daraï
D000328:Adult; D003106:Colon / Q000601:surgery; D003108:Colonic Diseases / Q000601:surgery*; D004715:Endometriosis / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008022:Ligaments / Q000601:surgery; D008137:Longitudinal Studies; D008875:Middle Aged; D010388:Pelvis / Q000294:innervation / Q000601:surgery; D010532:Peritoneal Diseases / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology* / Q000517:prevention & control; D012002:Rectal Diseases / Q000601:surgery*; D012007:Rectum / Q000601:surgery; D012447:Sacrum; D014555:Urination Disorders / Q000209:etiology*; D014591:Uterine Diseases / Q000601:surgery*; D014621:Vagina / Q000601:surgery; D014623:Vaginal Diseases / Q000601:surgery*