The impact of total laparoscopic excision of deep endometriosis (DE) on bladder and bowel dysfunction: a prospective longitudinal study

Morris JS, James S. Morris, Rajshekhar S, Smita Rajshekhar, Giulia Gremmo, Keane K, Katie Keane, Saikat Banerjee, Banerjee S
European journal of obstetrics, gynecology, and reproductive biology · 2025 · vol. 318 , pp. 114924 · doi:10.1016/j.ejogrb.2025.114924 · PMID:41483609 · W7117475332
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Total laparoscopic excision of deep endometriosis significantly improves bladder and bowel dysfunction in affected patients over a 12-month period.

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Abstract

Deep endometriosis (DE) is established to cause chronic pelvic pain (CPP), lower urinary tract symptoms (LUTS) and altered bowel function. Although the aim of surgical excision is often to relieve CPP, evidence suggests it could also affect LUTS and bowel symptoms, especially where DE affects the bowel or urinary tract. We assessed the prevalence and improvements in CPP, LUTS and bowel symptoms in 130 patients preoperatively and 6 months following total excision of endometriosis using the British Society for Gynaecological Endoscopy (BSGE) Pelvic Pain Questionnaire. Pain symptoms and LUTS are graded 0-10 whilst bowel function is scored 0-4, each using Likert scales. Patients with urinary tract DE reported median bladder pain and bladder voiding dysfunction of 7/10 (95 % CI: 3-8) and 7/10 (95 % CI: 0-9), respectively. Improvements at follow-up did not reach statistical significance at the Šidák-adjusted significance threshold, although 80.0 % and 60.0 % of patients reported clinically important improvements to these respective symptoms. There were also no cases of de novo LUTS following excision of urinary tract DE. Patients with bowel DE reported CPP and menstrual dyschezia of 7/10 (95 % CI: 6-8) and 8/10 (95 % CI: 4-8), respectively. Although a significant proportion of patients with bowel DE reported clinically important improvements in bowel symptoms, the difference in symptomatic severity failed to reach statistical significance. Whilst excision of DE can produce clinically important improvements in LUTS and bowel symptoms in a large proportion of patients, there is also a considerable risk of occasioning de novo bowel symptoms.

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Condition tags

endometriosischronic_pelvic_pain

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis

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.

References (28)

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