[Urinary functional disorders bound to deep endometriosis and to its treatment: review of the literature].
Lower urinary tract disorders in case of deep endometriosis are common (up to 50% of patients), although often masked by pelvic pain. They result from damage to the pelvic autonomic nervous system by direct infiltration of these structures by endometriotic lesions or surgical trauma (especially in resection of the uterosacral ligaments, rectum or vagina). These are mainly sensory disturbances and bladder voiding dysfunction. They impact quality of life and could be responsible for long-term complications (recurrent urinary tract infections on a persistent residual urine or pelvic floor disorders due to chronic thrusting). It is therefore important to diagnose and treat early these troubles by well-conducted interviews or standardized questionnaires. Different drug treatments have been proposed, such as cholinergics or prokinetics, but their effectiveness has not been demonstrated yet. Neuromodulation of the superior hypogastric plexus for treatment of refractory atonic bladder with persistent urinary retention after surgery seems promising but should be confirmed by further studies. To date, standard treatment of urinary retention after surgery remains self-catheterization. In terms of prevention, surgical nerve sparing techniques have been developed in order to minimize intraoperative injury of pelvic nerve plexus and reduce postoperative morbidity.
Service de gynécologie obstétrique 2 et médecine de la reproduction, université Paris Descartes, Sorbonne Paris Cité, groupe hospitalier Cochin Broca Hôtel-Dieu, hopital Cochin Port-Royal, assistance publique-hopitaux de Paris, 53, avenue de l'Observatoire, 75014 Paris, France. Electronic address: laetitiacampin@yahoo.fr.
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Campin
Service de gynécologie obstétrique 2 et médecine de la reproduction, université Paris Descartes, Sorbonne Paris Cité, groupe hospitalier Cochin Broca Hôtel-Dieu, hopital Cochin Port-Royal, assistance publique-hopitaux de Paris, 53, avenue de l'Observatoire, 75014 Paris, France; Département génétique développement cancer, institut Cochin, université Paris Descartes, Inserm U1016, CNRS UMR8104, 75014 Paris, France. Electronic address: bruno.borghese@cch.aphp.fr.
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Borghese
Service de gynécologie obstétrique 2 et médecine de la reproduction, université Paris Descartes, Sorbonne Paris Cité, groupe hospitalier Cochin Broca Hôtel-Dieu, hopital Cochin Port-Royal, assistance publique-hopitaux de Paris, 53, avenue de l'Observatoire, 75014 Paris, France; Département génétique développement cancer, institut Cochin, université Paris Descartes, Inserm U1016, CNRS UMR8104, 75014 Paris, France.
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Marcellin
Service de gynécologie obstétrique 2 et médecine de la reproduction, université Paris Descartes, Sorbonne Paris Cité, groupe hospitalier Cochin Broca Hôtel-Dieu, hopital Cochin Port-Royal, assistance publique-hopitaux de Paris, 53, avenue de l'Observatoire, 75014 Paris, France; Département génétique développement cancer, institut Cochin, université Paris Descartes, Inserm U1016, CNRS UMR8104, 75014 Paris, France.
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Santulli
Service de gynécologie obstétrique 2 et médecine de la reproduction, université Paris Descartes, Sorbonne Paris Cité, groupe hospitalier Cochin Broca Hôtel-Dieu, hopital Cochin Port-Royal, assistance publique-hopitaux de Paris, 53, avenue de l'Observatoire, 75014 Paris, France.
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Bourret
Service de gynécologie obstétrique 2 et médecine de la reproduction, université Paris Descartes, Sorbonne Paris Cité, groupe hospitalier Cochin Broca Hôtel-Dieu, hopital Cochin Port-Royal, assistance publique-hopitaux de Paris, 53, avenue de l'Observatoire, 75014 Paris, France; Département génétique développement cancer, institut Cochin, université Paris Descartes, Inserm U1016, CNRS UMR8104, 75014 Paris, France.
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Chapron
D004715:Endometriosis / Q000150:complications* / Q000601:surgery; D005260:Female; D006801:Humans; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D014570:Urologic Diseases / Q000175:diagnosis / Q000209:etiology / Q000628:therapy
Deep endometriosis; Endométriose profonde; Nerve sparing surgery; Prevention; Prévention; Troubles fonctionnels urinaires; Urinary functional disorders