{"paper_id":"89c0519c-5cca-4265-830a-eb07f87b3548","body_text":"Résumé\nAprès exérèse chirurgicale des lésions d’endométriose profonde (ligmanet[s] utérosacré[s] ou lors d’une résection rectale), les troubles urinaires de novo peuvent affecter jusqu’à 30 % des patientes avec une altération de la vidange vésicale. Ces troubles urinaires sont dus à des lésions des branches nerveuses des plexus hypogastriques inférieurs, lésions qui peuvent être uniou bilatérales. En pré-opératoire, les patientes doivent être informées de ce risque potentiel. La chirurgie avec préservation nerveuse permet de réduire de façon significative la survenue de ces troubles urinaires. En postopératoire, quand le résidu postmictionnel est supérieur à 100 ml et afin de prévenir le risque de complications, la réalisation d’autosondages est recommandée. L’évolution est le plus souvent favorable après quelques jours d’autosondages. Le recours à des épreuves urodynamiques et à des explorations électrophysiologiques s’avère nécessaire uniquement en cas de persistance des troubles urinaires.\nAbstract\nUrinary side effects occur in nearly 30% of patients after surgical resection of deep pelvic endometriosis and include significant voiding disorders. Damage to the autonomic pelvic nerves resulting from extensive surgery (unilateral or bilateral uterosacral ligament resections and/or colorectal resection) can explain this high-rate of symptoms. Preoperatively, patients must be clearly informed of this potential risk. Nerve-sparing surgery conserving the inferior hypogastric nerves significantly reduces the incidence of these urinary symptoms. When postvoid residual urine is greater than 100 ml, and to avoid complications, self-catheterization should be recommended. Usually, symptoms subside after a few days of self-catheterization, and urodynamic testing is required only if symptoms persist after this treatment.\nRéférences\nWeed JC, Ray JE (1987) Endometriosis of the bowel. Obstet Gynecol 69: 727–730\nDarai E, Thomassin I, Barranger E, et al. (2005) Feasibility and clinical outcome of laparoscopic colorectal resection for endometriosis. Am J Obstet Gynecol 192: 394–400\nBazot M, Darai E, Hourani R, et al. (2004) Deep pelvic endometriosis: MR imaging for diagnosis and prediction of extension of disease. Radiology 232: 379–389\nChapron C, Fauconnier A, Dubuisson JB, et al. (2003) Deep infiltrating endometriosis: relation between severity of dysmenorrhoea and extent of disease. Hum Reprod 18: 760–766\nFauconnier A, Chapron C, Dubuisson JB, et al. (2002) Relation between pain symptoms and the anatomic location of deep infiltrating endometriosis. Fertil Steril 78: 719–726\nMacafee CH, Greer HL (1960) Intestinal endometriosis. A report of 29 cases and a survey of the literature. J Obstet Gynaecol Br Emp 67: 539–555\nCollinet P, Marcelli F, Villers A, et al. (2006) Management of endometriosis of the urinary tract. Gynecol Obstet Fertil 34: 347–352\nGarry R, Clayton R, Hawe J (2000) The effect of endometriosis and its radical laparoscopic excision on quality of life indicators. BJOG 107: 44–54\nRedwine DB, Wright JT (2001) Laparoscopic treatment of complete obliteration of the cul-de-sac associated with endometriosis: long-term follow-up of en bloc resection. Fertil Steril 76: 358–365\nRedwine DB, Koning M, Sharpe DR (1996) Laparoscopically assisted transvaginal segmental resection of the rectosigmoid colon for endometriosis. Fertil Steril 65: 193–197\nUrbach DR, Reedijk M, Richard CS, et al. (1998) Bowel resection for intestinal endometriosis. Dis Colon Rectum 41: 1158–1164\nThomassin I, Bazot M, Detchev R, et al. (2004) Symptoms before and after surgical removal of colorectal endometriosis that are assessed by magnetic resonance imaging and rectal endoscopic sonography. Am J Obstet Gynecol 190: 1264–1271\nFedele L, Bianchi S, Zanconato G, et al. (2005) Tailoring radicality in demolitive surgery for deeply infiltrating endometriosis. Am J Obstet Gynecol 193: 114–117\nAbbott J, Hawe J, Hunter D, et al. (2004) Laparoscopic excision of endometriosis: a randomized, placebo-controlled trial. Fertil Steril 82: 878–884\nDubernard G, Piketty M, Rouzier R, et al. (2006) Quality of life after laparoscopic colorectal resection for endometriosis. Hum Reprod 21: 1243–1247\nDarai E, Ackerman G, Bazot M, et al. (2007) Laparoscopic segmental colorectal resection for endometriosis: limits and complications. Surg Endosc 21(9): 1572–1577\nVignali M, Bianchi S, Candiani M, et al. (2005) Surgical treatment of deep endometriosis and risk of recurrence. J Minim Invasive Gynecol 12: 508–513\nAngioni S, Peiretti M, Zirone M, et al. (2006) Laparoscopic excision of posterior vaginal fornix in the treatment of patients with deep endometriosis without rectum involvement: surgical treatment and long-term follow-up. Hum Reprod 21: 1629–1634\nVolpi E, Ferrero A, Sismondi P (2004) Laparoscopic identification of pelvic nerves in patients with deep infiltrating endometriosis. Surg Endosc 18: 1109–1112\nDubernard G, Rouzier R, David-Montefiore E, et al. (2008) Urinary complications after surgery for posterior deep infiltrating endometriosis are related to the extent of dissection and to uterosacral ligament resection. J Minim Invasive Gynecol 15(2): 235–240\nDeffieux X, Raibaut P, Hubeaux K, et al. (2007) Voiding dysfunction after surgical resection of deeply infiltrating endometriosis: pathophysiology and management. Gynecol Obstet Fertil 35(Suppl 1): S8–S13\nPearl RK, Monsen H, Abcarian H (1986) Surgical anatomy of the pelvic autonomic nerves. A practical approach. Am Surg 52: 236–237\nMauroy B, Demondion X, Drizenko A, et al. (2003) The inferior hypogastric plexus (pelvic plexus); its importance in neural preservation techniques. Surg Radiol Anat 25: 6–15\nButler-Manuel SA, Buttery LD, A’Hern RP, et al. (2002) Pelvic nerve plexus trauma at radical and simple hysterectomy: a quantitative study of nerve types in the uterine supporting ligaments. J Soc Gynecol Investig 9: 47–56\nBaader B, Herrmann M (2003) Topography of the pelvic autonomic nervous system and its potential impact on surgical intervention in the pelvis. Clin Anat 16: 119–130\nVercellini P, Aimi G, Busacca M, et al. (2003) Laparoscopic uterosacral ligament resection for dysmenorrhea associated with endometriosis: results of a randomized, controlled trial. Fertil Steril 80: 310–319\nShirouzu K, Ogata Y, ArakI Y (2004) Oncologic and functional results of total mesorectal excision and autonomic nerve-preserving operation for advanced lower rectal cancer. Dis Colon Rectum 47: 1442–1447\nLiang JT, Lai HS, Lee PH (2007) Laparoscopic pelvic autonomic nerve-preserving surgery for patients with lower rectal cancer after chemoradiation therapy. Ann Surg Oncol 14: 1285–1287\nPossover M, Quakernack J, Chiantera V (2005) The LANN technique to reduce postoperative functional morbidity in laparoscopic radical pelvic surgery. J Am Coll Surg 201: 913–917\nLandi S, Ceccaroni M, Perutelli A, et al. (2006) Laparoscopic nerve-sparing complete excision of deep endometriosis: is it feasible? Hum Reprod 21: 774–781\nDubernard G, Rouzier R, Piketty M, et al. (2007) Assessment of the urinary side effects after surgery for deep pelvic endometriosis. Gynecol Obstet Fertil 35(Suppl 1): S1–S7\nMadeiro AP, Rufino AC, Sartori MG, et al. (2006) The effects of bethanechol and cisapride on urodynamic parameters in patients undergoing radical hysterectomy for cervical cancer. A randomized, double blind, placebo-controlled study. Int Urogynecol J Pelvic Floor Dysfunct 17: 248–252\nAuthor information\nAuthors and Affiliations\nCorresponding author\nRights and permissions\nAbout this article\nCite this article\nDubernard, G., Huissoud, C., de Saint-Hilaire, P. et al. Troubles urinaires associés au traitement chirurgical de l’endométriose profonde: intérêt de la chirurgie avec préservation nerveuse. Pelv Perineol 3, 193–198 (2008). https://doi.org/10.1007/s11608-008-0198-5\nPublished:\nIssue date:\nDOI: https://doi.org/10.1007/s11608-008-0198-5","source_license":"CC0","license_restricted":false}