Pelvic organ function before and after laparoscopic bowel resection for rectosigmoid endometriosis: a prospective, observational study

M Riiskjaer, Mads Riiskjær, Stinne Ravn Greisen, S Greisen, Marianne Glavind‐Kristensen, M Glavind-Kristensen, US Kesmodel, U S Kesmodel, Axel Forman, A Forman, Mikkel Seyer‐Hansen, M Seyer-Hansen
BJOG: An International Journal of Obstetrics & Gynaecology · 2016 · vol. 123(8) , pp. 1360–1367 · doi:10.1111/1471-0528.13975 · PMID:26956803 · W2295996704
article OA: bronze CC0 ⤵ 55 in-corpus citations
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Laparoscopic bowel resection for rectosigmoid endometriosis improved urinary and sexual function 1 year post-surgery, with increased defecation frequency but unchanged overall bowel function.

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Abstract

OBJECTIVE: To assess urinary, sexual, and bowel function before and after laparoscopic bowel resection for rectosigmoid endometriosis. DESIGN: Prospectively collected data regarding the function of the pelvic organs. SETTING: Tertiary endometriosis referral unit, Aarhus University Hospital. SAMPLE: A cohort of 128 patients who underwent laparoscopic bowel resection for endometriosis. METHODS: The International Consultation on Incontinence Questionnaire (ICIQ), Sexual Function-Vaginal Changes Questionnaire (SVQ), and the Low Anterior Resection Syndrome (LARS) questionnaire were answered before and after surgery. Non-invasive urodynamic testing was performed. MAIN OUTCOME MEASURES: Pre- and postoperative function of the pelvic organs was compared, and risk factors for improved/impaired function were identified. RESULTS: A total of 96.1% of the women completed the 1-year follow-up. A significant decrease (P = 0.002) in bladder filling problems (F-score) was observed 1 year after surgery, primarily caused by a significant decrease in bladder pain (P = 0.0001). No change for urodynamic parameters was observed. A significant increase in overall sexual satisfaction (P = 0.0001) and decrease in worries about sexual life (P = 0.001) was seen 1 year after surgery. Frequency of defecation was significantly increased 1 year after surgery (P = 0.0001), but the overall bowel function measured by LARS score was unchanged. Patients with anastomotic leakage had a significantly higher risk (odds ratio, OR 5.40; P = 0.002) of increased incontinence problems (I-score) 1 year after surgery. CONCLUSION: A significant and clinically relevant improvement in urinary and sexual function 1 year after laparoscopic bowel resection for endometriosis was found. Except for anastomotic leakage, this could be observed independent of any patient- or treatment-related factor. Apprehension about impairment of urinary and sexual function should not be a contraindication for bowel resection in endometriosis patients. TWEETABLE ABSTRACT: Rectal resection for endometriosis does not impair urinary and sexual function 1 year after surgery.

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Condition tags

mesh:D004715endometriosis

MeSH descriptors

Defecation Digestive System Surgical Procedures Endometriosis Rectal Diseases Sexual Health Sigmoid Diseases Urination Adult Cohort Studies Colectomy Colon, Sigmoid Colon, Sigmoid Endometriosis Female Humans Laparoscopy Prospective Studies Rectal Diseases Rectum Rectum

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