title: Evaluation of urinary dysfunction by urodynamic tests, electromyography and quality of life questionnaire before and after surgery for deep infiltrating endometriosis.
abstract: OBJECTIVE
  To evaluate urinary dysfunction and quality of life before and after surgery for deep infiltrating endometriosis (DIE).
  
  
  METHODS
  This prospective study included 50 patients with DIE who required surgery. Urinary dysfunction was evaluated before and after surgery by both urodynamic tests and electromyography, and the Bristol Female Lower Urinary Tract Symptoms (BFLUTS) quality-of-life questionnaire.
  
  
  RESULTS
  Preoperative electromyography showed that 14 patients (28%) had neurogenic alteration involving sacral reflex and pelvic floor muscles correlated with the presence of colorectal endometriosis (p=0.003). Postoperative quality of life and BFLUTS total scores were improved compared to preoperative scores (p=0.001 and p=0.005, respectively). After an initial improvement in BFLUTS, an alteration is observed at long-term (median follow-up of 66 months). In the 34 patients with pre- and postoperative urodynamic measurements, no difference was found before and after surgery. De novo peripheral neuropathy was only observed in patients who underwent DIE resection with colorectal resection (p=0.02).
  
  
  CONCLUSIONS
  Our results support that patients with DIE have a high incidence of preoperative urinary symptoms and neurogenic dysfunction. Colorectal resection appears to be a determinant factor of de novo peripheral neuropathy.
authors: Department of Gynecology and Obstetrics, GRC-6 UPMC, Centre Expert en Endométriose (C3E), Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Université Pierre et Marie Curie, Paris 6, France.
authors: Marcos
authors: M
authors: Ballester
authors: Department of Gynecology and Obstetrics, GRC-6 UPMC, Centre Expert en Endométriose (C3E), Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Université Pierre et Marie Curie, Paris 6, France.
authors: Gil
authors: G
authors: Dubernard
authors: Department of Gynecology and Obstetrics, GRC-6 UPMC, Centre Expert en Endométriose (C3E), Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Université Pierre et Marie Curie, Paris 6, France.
authors: Estelle
authors: E
authors: Wafo
authors: Department of Gynecology and Obstetrics, GRC-6 UPMC, Centre Expert en Endométriose (C3E), Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Université Pierre et Marie Curie, Paris 6, France.
authors: Laura
authors: L
authors: Bellon
authors: Department of Neuro-urology and Electrophysiological Explorations, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Université Pierre et Marie Curie, Paris 6, France.
authors: Gérard
authors: G
authors: Amarenco
authors: Department of Gynecology and Obstetrics, GRC-6 UPMC, Centre Expert en Endométriose (C3E), Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Université Pierre et Marie Curie, Paris 6, France.
authors: Jeremie
authors: J
authors: Belghiti
authors: Department of Gynecology and Obstetrics, GRC-6 UPMC, Centre Expert en Endométriose (C3E), Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Université Pierre et Marie Curie, Paris 6, France. Electronic address: emile.darai@tnn.aphp.fr.
authors: Emile
authors: E
authors: Daraï
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004576:Electromyography; D004715:Endometriosis / Q000150:complications / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D014563:Urodynamics / Q000502:physiology*; D055815:Young Adult
keywords: BFLUTS; Deep infiltrating endometriosis; Electromyography; Neurogenic dysfunction; Urodynamic test