Prevalence of Urinary Symptoms in Women With Parametrial Endometriosis: Systematic Review and Meta-Analysis

A. Teixeira, Teixeira AI, Ana Isabel Teixeira, Rafael José Vieira, Vieira RJ, Margarida Martinho, Margarida Suzel Lopes Martinho, Martinho MSL, Diego Raimondo, Raimondo D, Alberto Aguzzi, Salmeri N, Noemi Salmeri, Lucia Lazzeri, Antonio Raffone, Raffone A, Stefano Scarperi, Scarperi S, Mabrouk M, Mohamed Mabrouk, Seracchioli R, Renato Seracchioli, Pinto PV, Pedro Viana Pinto
Journal of Minimally Invasive Gynecology · 2026 · doi:10.1016/j.jmig.2026.06.019 · PMID:42320749 · W7165379730
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This systematic review and meta-analysis found that dysuria and lower urinary tract symptoms (LUTS) are prevalent in women with parametrial endometriosis, with LUTS decreasing post-surgery but voiding dysfunction persisting in 14%.

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Abstract

OBJECTIVE: This study aimed to evaluate the prevalence of urinary symptoms in women with parametrial endometriosis before and after surgery. DATA SOURCES: We systematically searched MEDLINE, Web of Science, and Scopus through March 2025, with no language or publication year restrictions. Reference lists of included studies and relevant reviews were also screened. METHODS OF STUDY SELECTION: Studies reporting pre and/or postoperative urinary symptoms in women with parametrial endometriosis were included. A systematic review and meta-analysis, including 21 articles, was conducted. TABULATION, INTEGRATION, AND RESULTS: Data were extracted and categorized into dysuria, lower urinary tract symptoms (LUTS), and voiding dysfunction. Preoperatively, dysuria affected 15% (95% CI: 5-35) of women, with a mean VAS score of 1.10 (95% CI: 0.90-1.30). LUTS affected 27% (95% CI: 10-56), with a mean BFLUTS score of 13.23 (95% CI: -1.26 to 27.72). Voiding dysfunction was scarcely reported before surgery. Postoperatively, the prevalence of LUTS decreased to 13% (95% CI: 7-25), and the mean BFLUTS score to 7.84 (95% CI: -0.36 to 16.03). Voiding dysfunction was experienced in 14% of women (95% CI: 5-32), and 12% were symptoms that persisted after discharge (95% CI: 6-23). Subgroup analysis suggested a trend toward lower postoperative voiding dysfunction prevalence in patients with uterosacral involvement compared with those with lateral parametrium involvement. CONCLUSION: Urinary symptoms are common in women with parametrial endometriosis, and a significant proportion may persist after surgery. Parametrectomy appears to improve urinary function, with rare persistent complications. Careful parametrial evaluation, nerve-sparing techniques, and patient counselling are essential.

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