title: Urodynamic evaluation and anorectal manometry pre- and post-operative bowel shaving surgical procedure for posterior deep infiltrating endometriosis: a pilot study.
abstract: OBJECTIVE
  To analyze bowel and urinary function in patients with posterior deep infiltrating endometriosis (DIE) >30 mm in largest diameter at transvaginal ultrasound before and after surgical nerve-sparing excision.
  
  
  METHODS
  Prospective observational study (Canadian Task Force classification III).
  
  
  METHODS
  Tertiary care university hospital in Bologna, Italy.
  
  
  METHODS
  Twenty-five patients with posterior DIE were included in the study between June 2011 and December 2012. Patients did not receive hormone therapy for at least 3 months before and 6 months after surgery.
  
  
  METHODS
  Patients underwent urodynamic studies and anorectal manometry before and after nerve-sparing laparoscopic excision of the posterior DIE nodule.
  
  
  RESULTS
  Intestinal and urinary function was evaluated in patients with bulky posterior DIE using urodynamic and anorectal manometry. Results of urodynamic studies and anorectal manometry were similar before and after nerve-sparing surgical excision of the posterior DIE nodule. Urodynamic studies demonstrated a high prevalence of voiding dysfunction, whereas anorectal manometry showed no reduction in rectoanal inhibitory reflex and hypertone of the internal anal sphincter.
  
  
  CONCLUSIONS
  Patients with posterior DIE >30 mm in greatest diameter demonstrate preoperative dysfunction at urodynamic study and anorectal manometry, probably due to DIE per se. The nerve-sparing surgical approach seems not to influence the motility or sensory capacity of the bladder and the rectosigmoid colon.
authors.affiliation: Minimally Invasive Gynecological Surgery Unit, Sant'Orsola Hospital, University of Bologna, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Spagnolo
authors.affiliation: Minimally Invasive Gynecological Surgery Unit, Sant'Orsola Hospital, University of Bologna, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Zannoni
authors.affiliation: Minimally Invasive Gynecological Surgery Unit, Sant'Orsola Hospital, University of Bologna, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Raimondo
authors.affiliation: Minimally Invasive Gynecological Surgery Unit, Sant'Orsola Hospital, University of Bologna, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Ferrini
authors.affiliation: Gynecological Oncology and Minimally Invasive Pelvic Surgery Unit, Sacred Heart Hospital, Negrar, Verona, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Mabrouk
authors.affiliation: Minimally Invasive Gynecological Surgery Unit, Sant'Orsola Hospital, University of Bologna, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Benfenati
authors.affiliation: Minimally Invasive Gynecological Surgery Unit, Sant'Orsola Hospital, University of Bologna, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Villa
authors.affiliation: Minimally Invasive Gynecological Surgery Unit, Sant'Orsola Hospital, University of Bologna, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Bertoldo
authors.affiliation: Minimally Invasive Gynecological Surgery Unit, Sant'Orsola Hospital, University of Bologna, Italy. Electronic address: renato.seracchioli@aosp.bo.it.
authors.forename: Renato
authors.initials: R
authors.lastname: Seracchioli
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000294:innervation / Q000503:physiopathology; D004715:Endometriosis / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007558:Italy; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods / Q000534:rehabilitation; D008365:Manometry; D010865:Pilot Projects; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology; D011184:Postoperative Period; D057234:Preoperative Period; D011446:Prospective Studies; D012007:Rectum / Q000294:innervation / Q000503:physiopathology; D014563:Urodynamics
keywords: Anorectal manometry; Deep infiltrating endometriosis; Endometriosis; Nerve sparing; Urodynamic study