OBJECTIVE: To evaluate the impact of deep endometriosis (DE) on bladder function, focusing on detrusor pattern, in patients without preoperative urinary symptoms. DESIGN: Prospective study. SETTING: Academic research center. PATIENT(S): A total of 25 asymptomatic patients: 12 patients with DE (group 1) and 13 patients with ovarian endometriosis (group 2, control group). INTERVENTION(S): Preoperative urodynamic evaluation. MAIN OUTCOME MEASURE(S): The impact of DE on urodynamic parameters. RESULT(S): For the first time, a urodynamic diagnosis of detrusor overactivity was correlated with the presence of deep infiltrating endometriosis (group 1, 91.7% [11/12] vs. group 2, 7.7% [1/13]). All involuntary detrusor contractions were detected only during the filling phase. All cystometry parameters were found to be altered in group 1 and statistically different between the two groups. No pressure/flow study parameter significantly differed between the two groups, besides maximal detrusor pressure (46 cmH2O [33-79] vs. 29 cmH2O [15-40]), which was significantly higher in group 1. Therefore, all detrusor-related parameters are statistically different between the two groups. Postvoid residual does not reach a statistically significant difference. CONCLUSION(S): DE could significantly impair detrusor functions. A preoperative urodynamic evaluation allows the attainment of important functional information, even in asymptomatic patients.
OBJECTIVE: To evaluate the impact of deep endometriosis (DE) on bladder function, focusing on detrusor pattern, in patients without preoperative urinary symptoms. DESIGN: Prospective study. SETTING: Academic research center. PATIENT(S): A total of 25 asymptomatic patients: 12 patients with DE (group 1) and 13 patients with ovarian endometriosis (group 2, control group). INTERVENTION(S): Preoperative urodynamic evaluation. MAIN OUTCOME MEASURE(S): The impact of DE on urodynamic parameters. RESULT(S): For the first time, a urodynamic diagnosis of detrusor overactivity was correlated with the presence of deep infiltrating endometriosis (group 1, 91.7% [11/12] vs. group 2, 7.7% [1/13]). All involuntary detrusor contractions were detected only during the filling phase. All cystometry parameters were found to be altered in group 1 and statistically different between the two groups. No pressure/flow study parameter significantly differed between the two groups, besides maximal detrusor pressure (46 cmH2O [33-79] vs. 29 cmH2O [15-40]), which was significantly higher in group 1. Therefore, all detrusor-related parameters are statistically different between the two groups. Postvoid residual does not reach a statistically significant difference. CONCLUSION(S): DE could significantly impair detrusor functions. A preoperative urodynamic evaluation allows the attainment of important functional information, even in asymptomatic patients.
Authors: Luigi Carlo Turco; Giuseppe Vizzielli; Virginia Vargiu; Salvatore Gueli Alletti; Maria De Ninno; Gabriella Ferrandina; Luigi Pedone Anchora; Giovanni Scambia; Francesco Cosentino Journal: Front Oncol Date: 2021-11-15 Impact factor: 6.244