Prevalence of urinary dysfunction after minimally invasive surgery for deep rectosigmoid endometriosis

• Published in: Langenbeck's archives of surgery Vol. 408; no. 1; p. 83
• Main Authors: de Carvalho, Mariana de Sousa Ribeiro, Pellino, Gianluca, Pereira, Ana Maria Gomes, Bray-Beraldo, Fernando, Lopes, Reginaldo Guedes Coelho, Di Saverio, Salomone
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 11.02.2023
• Subjects: Abdominal Surgery; Cardiac Surgery; Colon - surgery; Endometriosis - complications; Endometriosis - epidemiology; Endometriosis - surgery; Female; General Surgery; Humans; Laparoscopy - adverse effects; Male; Medicine; Medicine & Public Health; Prevalence; Prospective Studies; Rectal Diseases - epidemiology; Rectal Diseases - surgery; Thoracic Surgery; Traumatic Surgery; Treatment Outcome; Vascular Surgery; Deep infiltrating endometriosis; Endometriosis; Colorectal surgery; Lower urinary tract symptoms
• ISSN: 1435-2451; 1435-2451
• DOI: 10.1007/s00423-023-02831-6

Purpose This study aimed to assess the prevalence and progression of lower urinary tract symptoms following laparoscopic surgery for deep-infiltrating endometriosis of the rectosigmoid and identify preoperative factors associated with worse postoperative outcomes. Methods Prospective, observational study. Settings: single-center, referral hospital for endometriosis. Patients undergoing laparoscopic surgery for deep-infiltrating endometriosis of the rectosigmoid colon between October 2016 and October 2018. Main outcome measures: urinary function was assessed with the validated Portuguese language version of the International Prostate Symptom Score, which is also used in women. The score was collected before and after surgery. The Wilcoxon signed-rank test was used to compare pre and postoperative scores and the chi-square test compared symptoms categorized by severity. Results Fifty-three patients were assessed and 44 were included. Concerning urinary symptoms after surgery, the irritative symptoms prevailed over the obstructive ones. Additionally, 58.8% and 54.5% of the women reported moderate or severe symptoms at pre and postoperative, respectively. In at least one questionnaire category, the postoperative questionnaire scores increased in ten (22.7%) participants. A statistically significant difference was found comparing the changes from absent/mild to moderate/severe IPSS categories ( P  = 0.039). No significant changes were identified in any of the International Prostate Symptom Score pre and postoperatively ( P  = 0.876). Conclusions There was a high prevalence of pre and postoperative urinary symptoms. Patients with preoperative moderate/severe International Prostate Symptom Score are at risk of persisting urinary dysfunction after surgery for rectosigmoid deep endometriosis.