title: Follow-up of dysfunctional bladder and rectum after surgery of a deep infiltrating rectovaginal endometriosis.
abstract: OBJECTIVE
  The radical surgery of the deep infiltrating endometriosis of the rectovaginal septum and the uterosacral ligaments with or without bowel resection can cause a serious damage of the pelvic autonomic nerves with urinary retention and the need of self-catheterization. Major goal of this review article is to compare different surgical techniques of deep infiltrating endometriosis and their follow-up results.
  
  
  METHODS
  The research strategy included the online search of databases [MEDLINE, EMBASE, SCOPUS] for the diagnosis of deep infiltrating endometriosis with the indication of an operative resection. The outcome of the follow-up terms were noticed and compared.
  
  
  RESULTS
  All in all, 16 trials could be identified with included follow-up. In all patients at least single-sided resection of the uterosacral ligaments were performed. Follow-up was heterogeneous in all trials ranging from 1 to 92 months. Postoperative symptoms, such as dysmenorrhoea, pelvic pain, and dyspareunia were commonly described in the majority of trials. Nevertheless, a tendency towards lower comorbidity after nerve sparing resection of endometriosis could be observed.
  
  
  CONCLUSIONS
  Identification of the inferior hypogastric nerve and plexus was feasible in the minority of trials. In comparison with non-nerve-sparing surgical technique, no cases of bladder self-catheterization for a long or even life time was observed, confirming the importance of the nerve-sparing surgical procedure.
authors.affiliation: Department of Gynecology and Obstretics, University of Schleswig-Holstein Campus Luebeck, Luebeck, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Kavallaris
authors.forename: I
authors.initials: I
authors.lastname: Mebes
authors.forename: D
authors.initials: D
authors.lastname: Evagyelinos
authors.forename: A
authors.initials: A
authors.lastname: Dafopoulos
authors.forename: D A
authors.initials: DA
authors.lastname: Beyer
mesh_terms: D004715:Endometriosis / Q000601:surgery*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D012002:Rectal Diseases / Q000209:etiology*; D016055:Urinary Retention / Q000209:etiology* / Q000517:prevention & control