Predictive Factors for Voiding Dysfunction after Surgery for Deep Infiltrating Endometriosis

Imboden S, Sara Imboden, Yaelle Bollinger, Bollinger Y, Kirsi Härmä, Härmä K, Knabben L, Laura Knabben, Mihaela Fluri, Fluri M, Konstantinos Nirgianakis, Nirgianakis K, Mohr S, Stefan Mohr, Kuhn A, Annette Kühn, Annette Kuhn, Mueller MD, Michael D Mueller
Journal of minimally invasive gynecology · 2021 · vol. 28(8) , pp. 1544–1551 · doi:10.1016/j.jmig.2021.01.009 · PMID:33476749 · W3125806535
article OA: closed CC0 ⤵ 17 in-corpus citations
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This study identified predictors of voiding dysfunction following surgery for deep infiltrating endometriosis, providing insights into patient risk factors.

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Abstract

Study objectiveTo evaluate the prognostic value of pre- and perioperative factors for voiding dysfunction after surgery for deep infiltrating endometriosis (DIE).DesignSingle-center retrospective cohort study.SettingUniversity hospital.PatientsA total of 198 women with DIE in the posterior compartment who underwent surgery and a postoperative bladder scan.InterventionsSurgical resection of the DIE nodule from the dorsal compartment.Measurements and main resultsAfter surgery, 41% of the patients initially experienced voiding dysfunction (defined as >100 mL postvoid residual urine volume at second bladder scan). The number decreased to 11% by the time of hospital discharge. Among those with a need for self-catheterization after discharge (n = 17), voiding dysfunction lasted for a median of 41 days before a return to normal bladder function, with a residual urine volume of <100 mL. The preoperative presence of DIE nodules in the ENZIAN compartment B was associated with postoperative voiding dysfunction (p = .001). The hazard ratio for elevated residual urine volume was highest when the disease stage was B3 (hazard ratio 6.43; CI, 2.3-18.2; p 3 cm in lateral distension. Receiver operating characteristic curve analyses showed that a first residual urine volume >220 mL has a good predictive value for the risk of intermittent self-catheterization (area under the receiver operating characteristic curve 0.893; p <.001).ConclusionPostoperative voiding dysfunction is frequent; of note, in most cases the problem is temporary. When DIE with an ENZIAN classification B is noted intraoperatively and, most of all, when the diameter of the lesion is >3 cm, a higher risk of postoperative voiding dysfunction is to be expected.

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Condition tags

endometriosisdie_deep_infiltrating

MeSH descriptors

Endometriosis Endometriosis Endometriosis Female Humans Postoperative Complications Postoperative Complications Postoperative Period Retrospective Studies

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