Urodynamic evaluation and anorectal manometry pre- and post-operative bowel shaving surgical procedure for posterior deep infiltrating endometriosis: a pilot study

E Spagnolo, Emanuela Spagnolo, Spagnolo E, Letizia Zannoni, L Zannoni, Diego Raimondo, D. Raimondo, G Ferrini, Ferrini G, Giulia Ferrini, M Mabrouk, Mohamed Mabrouk, A. Benfenati, Benfenati A, G Villa, Gioia Villa, Villa G, Bertoldo V, Valentina Bertoldo, V Bertoldo, Renato Seracchioli
Journal of Minimally Invasive Gynecology · 2014 · vol. 21(6) , pp. 1080–1085 · doi:10.1016/j.jmig.2014.05.012 · PMID:25544711 · W2089689442
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This pilot study evaluated urodynamic and anorectal manometry parameters before and after bowel shaving surgery for posterior deep infiltrating endometriosis to assess functional changes.

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Abstract

STUDY OBJECTIVE: To analyze bowel and urinary function in patients with posterior deep infiltrating endometriosis (DIE) >30 mm in largest diameter at transvaginal ultrasound before and after surgical nerve-sparing excision. DESIGN: Prospective observational study (Canadian Task Force classification III). SETTING: Tertiary care university hospital in Bologna, Italy. PATIENTS: Twenty-five patients with posterior DIE were included in the study between June 2011 and December 2012. Patients did not receive hormone therapy for at least 3 months before and 6 months after surgery. INTERVENTIONS: Patients underwent urodynamic studies and anorectal manometry before and after nerve-sparing laparoscopic excision of the posterior DIE nodule. MEASUREMENTS AND MAIN RESULTS: Intestinal and urinary function was evaluated in patients with bulky posterior DIE using urodynamic and anorectal manometry. Results of urodynamic studies and anorectal manometry were similar before and after nerve-sparing surgical excision of the posterior DIE nodule. Urodynamic studies demonstrated a high prevalence of voiding dysfunction, whereas anorectal manometry showed no reduction in rectoanal inhibitory reflex and hypertone of the internal anal sphincter. CONCLUSIONS: Patients with posterior DIE >30 mm in greatest diameter demonstrate preoperative dysfunction at urodynamic study and anorectal manometry, probably due to DIE per se. The nerve-sparing surgical approach seems not to influence the motility or sensory capacity of the bladder and the rectosigmoid colon.

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Condition tags

endometriosisdie_deep_infiltrating

MeSH descriptors

Endometriosis Laparoscopy Laparoscopy Laparoscopy Laparoscopy Laparoscopy Urodynamics Urodynamics Adult Adult Anal Canal Anal Canal Anal Canal Anal Canal Endometriosis Endometriosis Endometriosis Female Female Humans

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