Evaluation des troubles urinaires apres chirurgie de l'endometriose profonde Assessment of the urinary side effects after surgery for deep pelvic endometriosis

摘要

Objective - To evaluate the urinary side effects after laparoscopic surgery for deep endometriosis. Patients and method - Longitudinal study including 86 patients operated for deep pelvic endometriosis : 58 (68 %) with colorectal endometriosis, 21 (24 %) with utero-sacral ligament endometriosis and 7 (8 %) with recto-vaginal septum endometriosis. Assessment of the urinary side effects was permormed using the Bristole Female Lower Urinary Tract Symptom questionnaire. Results - On postsurgical follow-up, almost all patients described: hesistancy (p 0.02), strain to start (p (p=0.008) and reduce stream (p=0.02). Only patients who had resection of both utero-sacral ligaments had significative postsurgical urinary dysfunction with stopping flow (p=0.02) and incomplete emptying (p=0.004). Patients with colorectal resection had also significative postsurgical urinary dysfunction with hesitancy (p=0.02), strain to start (p=0.03), stopping flow (p=0.007) and incomplete emptying (p=0.004). In patients with rectal resection, urinary dysfunctions are raised when rectal resection is associated to resection of both utero-sacral ligaments. Conclusion - Postoperatively, urinary side effects occurred only in patients with segmental colorectal endometriosis resection associated with bilateral utero-sacral ligament resection. Sparing nerve surgery of the pelvic nerves, can reduce these urinary side effects.