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

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Abstract

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.

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Data Availability

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

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Author information

Authors and Affiliations

  1. Department of Gynecology, Hospital do Servidor Público Estadual de São Paulo, Pedro de Toledo Street, 1800, São Paulo, Vila Clementino, CEP 04039-004, Brazil

    Mariana de Sousa Ribeiro de Carvalho, Ana Maria Gomes Pereira & Reginaldo Guedes Coelho Lopes

  2. Department of Advanced Medical and Surgical Sciences, Università Studi della Campania “Luigi Vanvitelli”, Naples, Italy

    Gianluca Pellino

  3. Colorectal Surgery, Vall d’Hebron University Hospital, Universitat Autonoma de Barcelona UAB, Barcelona, Spain

    Gianluca Pellino

  4. Department of Digestive Surgery and Coloproctology, Hospital do Servidor Público Estadual de São Paulo, São Paulo, Brazil

    Fernando Bray-Beraldo

  5. Cambridge Endometriosis & Endoscopic Surgery Unit (CEESU) and Cambridge Colorectal Unit, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge, UK

    Salomone Di Saverio

  6. Department of General Surgery, University of Insubria, University Hospital of Varese, ASST Sette Laghi, Regione Lombardia, Italy

    Salomone Di Saverio

Authors
  1. Mariana de Sousa Ribeiro de Carvalho
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  2. Gianluca Pellino
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Contributions

Mariana de Sousa Ribeiro de Carvalho study conception design, collected data, performed the follow-up, applied the questionnaires, performed the bibliographic research, and wrote the article; Ana Maria Gomes Pereira study conception design, performed surgeries, collected data, performed data analysis and interpretation, and wrote the article; Fernando Bray Beraldo study conception design, performed surgeries and the follow-up, and critical revision; Reginaldo Guedes Coelho Lopes, Gianluca Pellino, and Salomone Di Saverio revised data analysis and edited the text/final approval of the manuscript. All authors discussed the results and commented on the manuscript for final approval of the article.

Corresponding author

Correspondence to Mariana de Sousa Ribeiro de Carvalho.

Ethics declarations

Ethical approval

This Research Ethics Committee of the IAMSPE/Hospital do Servidor Público Estadual, São Paulo, SP, Brazil approved this study (Opinion Number: 1,734,800, CAAE: 59528716.5.0000.546). All study participants provided written informed consent to join the study.

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The authors declare no competing interests.

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de Carvalho, M.R., Pellino, G., Pereira, A.M.G. et al. Prevalence of urinary dysfunction after minimally invasive surgery for deep rectosigmoid endometriosis. Langenbecks Arch Surg 408, 83 (2023). https://doi.org/10.1007/s00423-023-02831-6

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