Morbidité et conséquences fonctionnelles de la chirurgie de l’endométriose urinaire

Berling T, T. Berling, P-A Bolze, Bolze PA, Pierre‐Adrien Bolze, Berthiller J, J Berthiller, Julien Berthiller, Dubernard G, Gil Dubernard, G Dubernard, G. Lamblin, Lamblin G, Paparel P, P. Paparel, François Golfier, F. Golfier, Golfier F
Gynecologie, obstetrique, fertilite & senologie · 2017 · vol. 45(6) , pp. 327–334 · doi:10.1016/j.gofs.2017.05.006 · PMID:28552755 · W2618206409
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This paper reviews the morbidity and functional consequences of surgery for urinary endometriosis.

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Abstract

ObjectiveTo assess postoperative complications, improvement of pain symptoms and residual urinary functional symptoms after surgery for deep infiltrative endometriosis affecting ureter or bladder.MethodsRetrospective study of complications (Clavien-Dindo classification), pain (visual analog scale [VAS]) and urinary functional symptoms (Urinary Symptom Profile questionnaire [USP]) of patients surgically treated between 2007 and 2015 in University Hospitals of Lyon.ResultsAmong 31 patients with endometriosis involving the bladder, 83.9% had a partial cystectomy and 16.1% an extra-mucosal resection. Among patients (n=20) with ureteral involvement, 85% had ureterectomy with ureterocystoneostomy and 15% had only ureterolysis. Grade III postoperative complications occurred in 6% and 0% of patients with bladder or ureteral surgery, respectively and no grade IV or V complications were reported. Mean bladder VAS dropped from 5.3±4.2 to 0.3±0.9 after a follow-up of 42 months (P<0.0001). In patients with ureteral involvement, mean flank VAS dropped from 3.6 to 0.9 after a follow-up of 33 months (P<0.0005). Mean postoperative USP score for dysuria and detrusor overactivity were 1.35/9 and 2.48/21 in case of bladder involvement, and 1.10/9 and 2.15/21 in case of ureteral involvement.ConclusionMultidisciplinary surgical management of deep infiltrative endometriosis affecting urinary tract was associated to a low risk of severe postoperative complications and to a long-term significant improvement of pain symptoms without significant residual functional urinary symptoms.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Postoperative Complications Ureteral Diseases Urinary Bladder Diseases Urologic Surgical Procedures Adult Endometriosis Female Humans Pain Pain Postoperative Complications Retrospective Studies Treatment Outcome Ureteral Diseases Urinary Bladder Diseases Urologic Surgical Procedures

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