Bowel dysfunction before and after surgery for endometriosis

Horace Roman, Roman H, Bridoux V, Valérie Bridoux, Jean Jacques Tuech, Jean‐Jacques Tuech, Tuech JJ, Marpeau L, Loic Marpeau, Loı̈c Marpeau, Da Costa C, Carla Da Costa, Guillaume Savoye, Puscasiu L, Lucian Pușcașiu, Lucian Puscasiu
American journal of obstetrics and gynecology · 2013 · vol. 209(6) , pp. 524–530 · doi:10.1016/j.ajog.2013.04.015 · PMID:23583209 · W1989847657
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This study investigated bowel dysfunction in patients before and after endometriosis surgery, aiming to understand the impact of the procedure on these symptoms.

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Abstract

The relationship between deep fibrotic endometriosis of the rectum and digestive symptoms as well as the impact of surgical treatment on digestive complaints appears increasingly complex. With the exception of cases in which the disease leads to rectal stenosis, it seems likely that certain digestive symptoms are a result of cyclic inflammatory phenomena leading to irritation of the digestive tract and not necessarily the result of actual involvement of the rectum by the disease itself because they frequently occur in women free of rectal nodules. Functional or inflammatory bowel diseases and rectal hypersensitivity may be associated with pelvic endometriosis and consequently joepardize the hypothetical causal relationship between the presence of a rectal nodule and digestive complaints. Women treated surgically for rectal endometriosis may continue to experience postoperative digestive complaints, such as constipation. Despite successful surgery free of intra- and postoperative complications and significant improvement in well-being and pelvic pain, several unpleasant digestive symptoms may be incompletely cured by the surgery. Furthermore, de novo postoperative digestive complaints may occur after rectal surgery. Retrospective data suggest that performing colorectal resection is related to less favorable digestive functional outcomes than the use of conservative procedures such as shaving or full-thickness disc excision. These hypotheses need to be confirmed by prospective randomized trials comparing rectal radical and conservative approaches. Bearing in mind the complex relationship between rectal nodules, digestive symptoms and rectal surgery, particular care must be taken in the preoperative assessment of digestive function and in choosing the most suitable surgical procedure.

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Condition tags

endometriosis

MeSH descriptors

Colorectal Surgery Constipation Endometriosis Postoperative Complications Rectal Diseases Rectum Colorectal Surgery Constipation Endometriosis Endometriosis Endometriosis Female Humans Postoperative Complications Rectal Diseases Rectal Diseases Rectum Treatment Outcome

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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Cited by (50)

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