Contribution of sacral neuromodulation to manage persistent voiding dysfunction after surgery for deep infiltrating endometriosis with colorectal involvement: preliminary results

Nyangoh Timoh K, Krystel Nyangoh Timoh, Canlorbe G, Geoffroy Canlorbe, Verollet D, Delphine Verollet, D. Vérollet, Laurence Peyrat, L. Peyrat, Peyrat L, Marcos Ballester, Ballester M, Amarenco G, G. Amarenco, Gérard Amarenco, Darai E, Emile Darai, Émile Daraï
European journal of obstetrics, gynecology, and reproductive biology · 2015 · vol. 190 , pp. 31–35 · doi:10.1016/j.ejogrb.2015.04.011 · PMID:25966436 · W2076979577
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This study investigated the effectiveness of sacral neuromodulation in managing persistent voiding dysfunction following surgical treatment for deep infiltrating endometriosis involving the colorectal region.

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Abstract

ObjectiveAround 5% of women experience persistent voiding dysfunction after surgery for deep infiltrating endometriosis (DIE) with colorectal involvement. The gold standard to manage persistent voiding dysfunction is intermittent self-catherization, but this treatment may reduce quality of life of the patients due to care constraints. The objective of our study was to assess the contribution of sacral neuromodulation (SNM) in the management of persistent voiding dysfunction secondary to surgery for DIE with colorectal resection.Study designFive patients referred for persistent voiding dysfunction after surgery for DIE with colorectal resection were included and fitted with a temporary SNM system to test for feasibility. This consisted of placing an electrode unilaterally next to the S3 sacral nerve root and connecting it to an external pacemaker. The patients wore the electrode and the external neurostimulator for 21 days and kept a voiding diary. The SNM test was considered positive when a 50% decrease in self-catheterization was achieved after removal of the electrode. The system was implanted permanently in patients with a positive SNM test. Urodynamic tests were performed before and after the SNM test.ResultsTwo of the five patients had a positive SNM test and were implanted permanently. At 40 months the first patient had completely stopped self-catheterization and the second patient was performing self-catheterization twice a day with a post voiding residue volume of less than 100ml at 52 months.ConclusionSNM could be a curative technique in some patients with persistent voiding dysfunction after surgery for DIE. Further studies are required to better select patients who might benefit from SNM testing and subsequent device implantation.

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Condition tags

endometriosisdie_deep_infiltrating

MeSH descriptors

Colonic Diseases Electric Stimulation Therapy Endometriosis Rectal Diseases Urination Disorders Adult Colectomy Colectomy Colonic Diseases Colonic Diseases Electrodes, Implanted Endometriosis Endometriosis Female Humans Intermittent Urethral Catheterization Lumbosacral Plexus Rectal Diseases Rectal Diseases Retrospective Studies

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