Les techniques de préservation nerveuse dans la chirurgie de l’endométriose profonde pour prévenir les séquelles fonctionnelles urinaires et digestives : modalités techniques et résultats. RPC Endométriose CNGOF-HAS

B. Rabischong, Rabischong B, R. Botchorishvili, Nicolas Bourdel, N Bourdel, Bourdel N, S. Curinier, Curinier S, S. Campagne-Loiseau, Campagne-Loiseau S, Jean Luc Pouly, J L Pouly, Pouly JL, Michel Canis, M Canis
Gynecologie, obstetrique, fertilite & senologie · 2018 · vol. 46(3) , pp. 309–313 · doi:10.1016/j.gofs.2018.02.031 · PMID:29551299 · W2790832631
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This paper reviews technical approaches for nerve preservation during deep endometriosis surgery to prevent urinary and digestive functional deficits.

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Abstract

ObjectivesTo evaluate the feasibility and functional urinary and digestive results of nerve sparing techniques in endometriosis surgery.MethodsA research on the medline/pubmed database using specific keywords (nerve sparing, endometriosis, pelvic nerves) identified 7 publications among about 50 whose purpose was to describe the feasibility, the techniques and the functional results of nerve preservation in this indication. Among them there are: 2 uncontrolled retrospective studies, 3 prospective non-randomized studies, a meta-analysis and a review of the literature.ResultsNerve preservation requires a perfect knowledge of the anatomy of the pelvic autonomic system. The laparoscopic approach is preferred by the different authors due to its anatomical advantage. The feasibility of this technique seems to be demonstrated despite certain limitations in the different studies and depending of the retroperitoneal extension of the lesions. When feasible, it is likely to significantly improve postoperative urinary function (urinary retention) compared to a conventional technique. It is observed no difference regarding digestive function.ConclusionsNerve sparing in this indication is a technique the feasibility of which has been demonstrated and is subject to the topography and extent of the disease. In the absence of invasion or entrapment of pelvic autonomic nerves by endometriosis, this technique improves postoperative voiding function (NP3). During pelvic surgery for endometriosis, it is recommended to identify and preserve autonomic pelvic nerves whenever possible (GradeC).

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Peripheral Nerve Injuries Endometriosis Female Humans Hypogastric Plexus Laparoscopy Organ Sparing Treatments Pelvis Pelvis Peripheral Nerve Injuries Urination Disorders Urination Disorders

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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License: CC0 · commercial use OK