Marcos Ballester1, Gil Dubernard1, Estelle Wafo1, Laura Bellon1, Gérard Amarenco2, Jeremie Belghiti1, Emile Daraï3. 1. 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. 2. Department of Neuro-urology and Electrophysiological Explorations, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Université Pierre et Marie Curie, Paris 6, France. 3. 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.
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.
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: Manuel Maria Ianieri; Diego Raimondo; Andrea Rosati; Laura Cocchi; Rita Trozzi; Manuela Maletta; Antonio Raffone; Federica Campolo; Giuliana Beneduce; Antonio Mollo; Paolo Casadio; Ivano Raimondo; Renato Seracchioli; Giovanni Scambia Journal: Int J Gynaecol Obstet Date: 2022-01-20 Impact factor: 4.447