title: Endometriosis and Vesico-Sphincteral Disorders.
abstract: OBJECTIVE
  The aim of this mini review is to determine the relationship between endometriosis and urinary tract symptoms and to investigate the consequences of surgical treatment of mild to severe endometriosis, especially deep lesions, on the vesico-sphincteral function (lower urinary tract function).
  
  
  METHODS
  We performed a literature review by searching the MEDLINE database for articles published between 2000 and 2014, limiting the searches to the words: urinary tract, vesico-sphincteral, dysfunction, endometriosis, symptoms, and surgery.
  
  
  RESULTS
  The incidence of vesico-sphincteral symptoms in endometriosis varies from 3.4 up to 15.4%. The frequency of such symptoms seems to be under estimated because of a lack of specific questionnaire including urinary symptoms. Urodynamic evaluation could help to detect unsuspected abnormalities. It seems that endometriosis surgery (particularly deep infiltrating lesions) is a purveyor of de novo urinary dysfunction, with an incidence varying from 6.8 up to 17.5%. Nerve sparing processes such as neuro-navigators or neuro-stimulators seem to be promising techniques to avoid postoperative urinary tract dysfunction.
  
  
  CONCLUSIONS
  A precise anamnesis and the use of specific validated questionnaires (IPSS and BFLUTS) improve the screening of vesico-sphincteral symptoms in case of endometriosis. No recommendation can be found in the literature about the place of urodynamic evaluation. Most publications lack of proof and therefore do not allow making recommendations about optimal treatment of endometriotic lesions to avoid urinary tract disorders.
authors.affiliation: Service de Gynécologie Obstétrique, HFR Fribourg - Hôpital Cantonal , Fribourg , Switzerland ; Service de Gynécologie Obstetrique et de Médecine de la reproduction de l'Hôpital Aziza Othmana , Tunis , Tunisia ; Faculté de Médecine de Tunis , Tunis , Tunisia.
authors.forename: Anis
authors.initials: A
authors.lastname: Fadhlaoui
authors.affiliation: Service de Gynécologie Obstétrique, HFR Fribourg - Hôpital Cantonal , Fribourg , Switzerland.
authors.forename: Tessa
authors.initials: T
authors.lastname: Gillon
authors.affiliation: Obstetric Gynecology and Fertility Private Clinic, Dream Center , Tunis , Tunisia.
authors.forename: Issam
authors.initials: I
authors.lastname: Lebbi
authors.affiliation: Service de Gynécologie Obstétrique, HFR Fribourg - Hôpital Cantonal , Fribourg , Switzerland.
authors.forename: Jean
authors.initials: J
authors.lastname: Bouquet de Jolinière
authors.affiliation: Service de Gynécologie Obstétrique, HFR Fribourg - Hôpital Cantonal , Fribourg , Switzerland.
authors.forename: Anis
authors.initials: A
authors.lastname: Feki
keywords: bladder; deep endometriosis; endometriosis; sphincter; surgery; urinary tract