title: Persistent urinary retention after surgery for deep infiltrating endometriosis: a multi-center series of 16 cases.
abstract: OBJECTIVE
  Persistent urinary retention (UR) is a complication of 3.5-14.3% of patients having undergone deep pelvic endometriosis (DPE) surgery of posterior compartment, and it is prone to persist. The purpose of this study is to identify surgical procedures and clinical circumstances associated with persistent UR, and consider its treatment.
  
  
  METHODS
  We undertook a multi-center retrospective study studying medical records of patients who had surgery for DPE between January 2005 and December 2012. Patients who suffered from UR defined as a post-void residual (PVR) volume >100 mL needing intermittent self-catheterizations more than 30 days after surgery were included. Preoperative data (functional complaints, clinical examination, imaging, medical treatment) were recorded. Types of surgery and detailed postoperative urinary symptoms were noted.
  
  
  RESULTS
  881 patients had surgery for DPE and 16 patients were included (1.8%). In 93.8% of cases, a lesion of posterior compartment was clinically significant. Mean lesion size was 28.8 ± 7.3 mm. Colorectal resection and colpectomy were necessary in 93.8 and 87.5% of cases, respectively. Loss of bladder sensation and straining during urination were the two most common post-operative symptoms. 11 patients still required self-catheterization up to 1 year after the intervention.
  
  
  CONCLUSIONS
  Patients with increased risks of UR present with a symptomatic and clinically palpable deep pelvic endometriotic lesion of the posterior compartment. Treatment implies surgery with colorectal resection. Bilateral resection of utero-sacral ligaments and posterior colpectomy tend to increase that risk. Complications due to PVR volume and straining during urination may be prevented by self-catheterization.
authors.affiliation: Gynecology Department, Jeanne de Flandre, CHRU, 59000, Lille, France, henriazais@gmail.com.
authors.forename: Henri
authors.initials: H
authors.lastname: Azaïs
authors.forename: Chrystèle
authors.initials: C
authors.lastname: Rubod
authors.forename: Tarek
authors.initials: T
authors.lastname: Ghoneim
authors.forename: Maud
authors.initials: M
authors.lastname: Vassilieff
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Bailly
authors.forename: Laurent
authors.initials: L
authors.lastname: Boileau
authors.forename: Richard
authors.initials: R
authors.lastname: Villet
authors.forename: Pierre
authors.initials: P
authors.lastname: Collinet
mesh_terms: D000328:Adult; D000368:Aged; D002404:Catheterization / Q000009:adverse effects*; D004715:Endometriosis / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012002:Rectal Diseases / Q000601:surgery*; D012189:Retrospective Studies; D016055:Urinary Retention / Q000209:etiology*; D014555:Urination Disorders / Q000453:epidemiology / Q000209:etiology