José Anacleto Dutra de Resende Júnior1,2,3, Claudio Peixoto Crispi4, Leon Cardeman5, Renata Teles Buere6, Márlon de Freitas Fonseca6. 1. Department of Urology, Lagoa Federal Hospital, Rua Jardim Botânico 501-6° andar, Jardim Botânico, Rio de Janeiro, Brazil. joseanacletojunior@gmail.com. 2. Department of Urology, Pedro Ernesto University Hospital, Rio de Janeiro State University, Boulevard Vinte e Oito de Setembro 77- 5° andar, Vila Isabel, Rio de Janeiro, Brazil. joseanacletojunior@gmail.com. 3. Crispi Institute of Minimally Invasive Surgery, Av. das Américas 3434 B4 216, Barra da Tijuca, Rio de Janeiro, Brazil. joseanacletojunior@gmail.com. 4. Crispi Institute of Minimally Invasive Surgery, Av. das Américas 3434 B4 216, Barra da Tijuca, Rio de Janeiro, Brazil. 5. Labcardeman, Av. Nossa Senhora de Copacabana 1066 - 409. Copacabana, Rio de Janeiro, Brazil. 6. Department of Anesthesia, Fernandes Figueira National Institute for Women, Children and Youth Health (IFF), Oswaldo Cruz Foundation, Av. Rui Barbosa 716 - 3° andar, Flamengo, Rio de Janeiro, Brazil.
Abstract
INTRODUCTION AND HYPOTHESIS: The objective was to assess the association between lower urinary tract disease (LUTD) and the presence of endometriosis at different anatomical sites. METHODS: Our prospective cross-sectional observational study evaluated 138 women with deep infiltrating endometriosis who had undergone preoperative evaluation of urodynamics and detailed assessment of lower urinary tract symptoms between August 2013 and May 2016. After laparoscopy, the anatomical sites of histologically confirmed endometriosis lesions were mapped. RESULTS: The presence of endometriosis in the bladder demonstrated significant negative angular coefficients for bladder compliance (mL/cmH2O) (P = 0.007; B = -54.65; 95%CI: -93.76 to -15.51) and for maximum cystometric capacity (mL; P = 0.001; B = -39.79; 95%CI: -62.51 to -17.06), whereas endometriosis in the parametrium showed significant positive coefficients for opening pressure (cmH2O) (P = 0.016; B = 5.89; 95%CI: 1.10-10.69) and post-void residual (mL) (P = 0.015; B = 31.34; 95%CI: 6.14-56.55). The presence of endometriosis in the bladder was a statistically significant independent predictor of low bladder compliance (P < 0.001; OR = 30.10; 95%CI: 9.48-95.55), whereas endometriosis in the parametrium was a statistically significant independent predictor of both abnormal residual urine (P = 0.019; OR = 5.21; 95%CI: 1.32-20.64) and bladder outlet obstruction (P = 0.011; OR = 7.91; 95%CI: 1.61-38.86). Correspondence analysis suggested two possible independent ways through which endometriosis acts on the genesis of urinary dysfunctions. CONCLUSIONS: Our findings strongly suggest that endometriosis involving the bladder might disturb storage function, whereas endometriosis in the parametrium disturbs the voiding phase.
INTRODUCTION AND HYPOTHESIS: The objective was to assess the association between lower urinary tract disease (LUTD) and the presence of endometriosis at different anatomical sites. METHODS: Our prospective cross-sectional observational study evaluated 138 women with deep infiltrating endometriosis who had undergone preoperative evaluation of urodynamics and detailed assessment of lower urinary tract symptoms between August 2013 and May 2016. After laparoscopy, the anatomical sites of histologically confirmed endometriosis lesions were mapped. RESULTS: The presence of endometriosis in the bladder demonstrated significant negative angular coefficients for bladder compliance (mL/cmH2O) (P = 0.007; B = -54.65; 95%CI: -93.76 to -15.51) and for maximum cystometric capacity (mL; P = 0.001; B = -39.79; 95%CI: -62.51 to -17.06), whereas endometriosis in the parametrium showed significant positive coefficients for opening pressure (cmH2O) (P = 0.016; B = 5.89; 95%CI: 1.10-10.69) and post-void residual (mL) (P = 0.015; B = 31.34; 95%CI: 6.14-56.55). The presence of endometriosis in the bladder was a statistically significant independent predictor of low bladder compliance (P < 0.001; OR = 30.10; 95%CI: 9.48-95.55), whereas endometriosis in the parametrium was a statistically significant independent predictor of both abnormal residual urine (P = 0.019; OR = 5.21; 95%CI: 1.32-20.64) and bladder outlet obstruction (P = 0.011; OR = 7.91; 95%CI: 1.61-38.86). Correspondence analysis suggested two possible independent ways through which endometriosis acts on the genesis of urinary dysfunctions. CONCLUSIONS: Our findings strongly suggest that endometriosis involving the bladder might disturb storage function, whereas endometriosis in the parametrium disturbs the voiding phase.
Authors: Paul Abrams; Linda Cardozo; Magnus Fall; Derek Griffiths; Peter Rosier; Ulf Ulmsten; Philip van Kerrebroeck; Arne Victor; Alan Wein Journal: Neurourol Urodyn Date: 2002 Impact factor: 2.696
Authors: Werner Schäfer; Paul Abrams; Limin Liao; Anders Mattiasson; Francesco Pesce; Anders Spangberg; Arthur M Sterling; Norman R Zinner; Philip van Kerrebroeck Journal: Neurourol Urodyn Date: 2002 Impact factor: 2.696