{"paper_id":"9e02f498-611b-4db6-9d04-e641188627cd","body_text":"Abstract\nIntroduction and hypothesis\nPatients with deep infiltrating pelvic endometriosis (DIE) often describe having lower urinary tract symptoms (LUTS). Bladder pain syndrome in women is also often associated with endometriosis. In this study, we aimed to describe the characteristics of LUTS and urodynamic observations in patients with posterior endometriosis versus those with posterior and anterior endometriosis.\nMethods\nThis was a prospective observational study of 30 patients from two gynecologic surgical settings with experience in DIE surgery. All patients underwent preoperative standardized investigation including detailed evaluation of LUTS and urodynamic studies. During surgery, endometriosis locations were recorded and correlated to symptoms and urodynamic observations.\nResults\nTwenty-three patients (76.7 %) had one or more LUTS symptoms and 29 (96.7 %) had one or more abnormalities at urodynamic examination. At surgery, all patients had posterior endometriosis and ten of them also had anterior endometriosis. Patients with anterior endometriosis had increased bladder sensation (90.0 % versus 45.0 %, p = 0.024) and painful bladder filling (70.0 % versus 30.0, p = 0.04) compared with patients with posterior endometriosis only. Voiding symptoms (60.0 %), impairment of flowmetry (30.0 %), and increased maximum urethral closure pressure (90.0 %) were frequent and not correlated with any specific location.\nConclusions\nEndometriosis infiltrating the bladder wall is associated with painful bladder symptoms. Dysfunctional voiding suggests an impairment of the inferior hypogastric plexus by posterior DIE. Clinical preoperative evaluation of bladder function should be systematic; urodynamic tests could be of interest in selected patients with DIE. Endometriosis may be a major cause of bladder pain syndrome.\nSimilar content being viewed by others\nReferences\nCramer DW, Missmer SA (2002) The epidemiology of endometriosis. Ann N Y Acad Sci 955:11–22, discussion 34-16, 396-406\nKoninckx PR, Martin D (1994) Treatment of deeply infiltrating endometriosis. Curr Opin Obstet Gynecol 6(3):231–241\nFauconnier A, Chapron C (2005) Endometriosis and pelvic pain: epidemiological evidence of the relationship and implications. Hum Reprod Update 11(6):595–606\nChapron C, Fauconnier A, Vieira M, Barakat H, Dousset B, Pansini V, Vacher-Lavenu MC, Dubuisson JB (2003) Anatomical distribution of deeply infiltrating endometriosis: surgical implications and proposition for a classification. 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Fertil Steril 91(1):32–39\nFowler CJ, Christmas TJ, Chapple CR, Parkhouse HF, Kirby RS, Jacobs HS (1988) Abnormal electromyographic activity of the urethral sphincter, voiding dysfunction, and polycystic ovaries: a new syndrome? BMJ 297(6661):1436–1438\nConflicts of interest\nNone.\nStudy funding\nNone.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nRights and permissions\nAbout this article\nCite this article\nPanel, P., Huchon, C., Estrade-Huchon, S. et al. Bladder symptoms and urodynamic observations of patients with endometriosis confirmed by laparoscopy. Int Urogynecol J 27, 445–451 (2016). https://doi.org/10.1007/s00192-015-2848-9\nReceived:\nAccepted:\nPublished:\nIssue date:\nDOI: https://doi.org/10.1007/s00192-015-2848-9","source_license":"public-domain-us","license_restricted":false}