Skip to main content
Erschienen in: Archives of Gynecology and Obstetrics 5/2011

01.05.2011 | General Gynecology

Follow-up of dysfunctional bladder and rectum after surgery of a deep infiltrating rectovaginal endometriosis

verfasst von: A. Kavallaris, I. Mebes, D. Evagyelinos, A. Dafopoulos, D. A. Beyer

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 5/2011

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The radical surgery of the deep infiltrating endometriosis of the rectovaginal septum and the uterosacral ligaments with or without bowel resection can cause a serious damage of the pelvic autonomic nerves with urinary retention and the need of self-catheterization. Major goal of this review article is to compare different surgical techniques of deep infiltrating endometriosis and their follow-up results.

Methods

The research strategy included the online search of databases [MEDLINE, EMBASE, SCOPUS] for the diagnosis of deep infiltrating endometriosis with the indication of an operative resection. The outcome of the follow-up terms were noticed and compared.

Results

All in all, 16 trials could be identified with included follow-up. In all patients at least single-sided resection of the uterosacral ligaments were performed. Follow-up was heterogeneous in all trials ranging from 1 to 92 months. Postoperative symptoms, such as dysmenorrhoea, pelvic pain, and dyspareunia were commonly described in the majority of trials. Nevertheless, a tendency towards lower comorbidity after nerve sparing resection of endometriosis could be observed.

Conclusion

Identification of the inferior hypogastric nerve and plexus was feasible in the minority of trials. In comparison with non-nerve-sparing surgical technique, no cases of bladder self-catheterization for a long or even life time was observed, confirming the importance of the nerve-sparing surgical procedure.
Literatur
1.
Zurück zum Zitat Anaf V et al (2000) Sigmoid endometriosis and ovarian stimulation. Hum Reprod 15(4):790–794PubMedCrossRef Anaf V et al (2000) Sigmoid endometriosis and ovarian stimulation. Hum Reprod 15(4):790–794PubMedCrossRef
2.
Zurück zum Zitat Koninckx PR et al (1991) Suggestive evidence that pelvic endometriosis is a progressive disease, whereas deeply infiltrating endometriosis is associated with pelvic pain. Fertil Steril 55(4):759–765PubMed Koninckx PR et al (1991) Suggestive evidence that pelvic endometriosis is a progressive disease, whereas deeply infiltrating endometriosis is associated with pelvic pain. Fertil Steril 55(4):759–765PubMed
3.
Zurück zum Zitat Ferrero S, Ragni N, Remorgida V (2008) Deep dyspareunia: causes treatments, and results. Curr Opin Obstet Gynecol 20(4):394–399PubMedCrossRef Ferrero S, Ragni N, Remorgida V (2008) Deep dyspareunia: causes treatments, and results. Curr Opin Obstet Gynecol 20(4):394–399PubMedCrossRef
4.
Zurück zum Zitat Beltran MA et al (2006) Ileal endometriosis as a cause of intestinal obstruction. Report of two cases]. Rev Med Chil 134(4):485–490PubMed Beltran MA et al (2006) Ileal endometriosis as a cause of intestinal obstruction. Report of two cases]. Rev Med Chil 134(4):485–490PubMed
5.
Zurück zum Zitat Kavallaris A et al (2003) Histopathological extent of rectal invasion by rectovaginal endometriosis. Hum Reprod 18(6):1323–1327PubMedCrossRef Kavallaris A et al (2003) Histopathological extent of rectal invasion by rectovaginal endometriosis. Hum Reprod 18(6):1323–1327PubMedCrossRef
6.
Zurück zum Zitat Houtmeyers P et al (2006) Surgery for gastrointestinal endometriosis: indications and results. Acta Chir Belg 106(4):413–416PubMed Houtmeyers P et al (2006) Surgery for gastrointestinal endometriosis: indications and results. Acta Chir Belg 106(4):413–416PubMed
7.
Zurück zum Zitat Chapron C et al (1997) Retroperitoneal endometriosis infiltrating the utero-sacral ligaments. Technique and results of laparoscopic surgery. J Gynecol Obstet Biol Reprod (Paris) 26(3):264–269 Chapron C et al (1997) Retroperitoneal endometriosis infiltrating the utero-sacral ligaments. Technique and results of laparoscopic surgery. J Gynecol Obstet Biol Reprod (Paris) 26(3):264–269
8.
Zurück zum Zitat Duepree HJ et al (2002) Laparoscopic resection of deep pelvic endometriosis with rectosigmoid involvement. J Am Coll Surg 195(6):754–758PubMedCrossRef Duepree HJ et al (2002) Laparoscopic resection of deep pelvic endometriosis with rectosigmoid involvement. J Am Coll Surg 195(6):754–758PubMedCrossRef
9.
Zurück zum Zitat Darai E et al (2007) Laparoscopic segmental colorectal resection for endometriosis: limits and complications. Surg Endosc 21(9):1572–1577PubMedCrossRef Darai E et al (2007) Laparoscopic segmental colorectal resection for endometriosis: limits and complications. Surg Endosc 21(9):1572–1577PubMedCrossRef
10.
Zurück zum Zitat Fleisch MC et al (2005) Radical resection of invasive endometriosis with bowel or bladder involvement—long-term results. Eur J Obstet Gynecol Reprod Biol 123(2):224–229PubMedCrossRef Fleisch MC et al (2005) Radical resection of invasive endometriosis with bowel or bladder involvement—long-term results. Eur J Obstet Gynecol Reprod Biol 123(2):224–229PubMedCrossRef
11.
Zurück zum Zitat Possover M et al (2000) Laparascopically assisted vaginal resection of rectovaginal endometriosis. Obstet Gynecol 96(2):304–307PubMedCrossRef Possover M et al (2000) Laparascopically assisted vaginal resection of rectovaginal endometriosis. Obstet Gynecol 96(2):304–307PubMedCrossRef
12.
Zurück zum Zitat Nezhat C, Nezhat F, Pennington E (1992) Laparoscopic treatment of infiltrative rectosigmoid colon and rectovaginal septum endometriosis by the technique of videolaparoscopy and the CO2 laser. Br J Obstet Gynaecol 99(8):664–667PubMedCrossRef Nezhat C, Nezhat F, Pennington E (1992) Laparoscopic treatment of infiltrative rectosigmoid colon and rectovaginal septum endometriosis by the technique of videolaparoscopy and the CO2 laser. Br J Obstet Gynaecol 99(8):664–667PubMedCrossRef
13.
Zurück zum Zitat Jerby BL et al (1999) Laparoscopic management of colorectal endometriosis. Surg Endosc 13(11):1125–1128PubMedCrossRef Jerby BL et al (1999) Laparoscopic management of colorectal endometriosis. Surg Endosc 13(11):1125–1128PubMedCrossRef
14.
Zurück zum Zitat Woods RJ, Heriot AG, Chen FC (2003) Anterior rectal wall excision for endometriosis using the circular stapler. ANZ J Surg 73(8):647–648PubMedCrossRef Woods RJ, Heriot AG, Chen FC (2003) Anterior rectal wall excision for endometriosis using the circular stapler. ANZ J Surg 73(8):647–648PubMedCrossRef
15.
Zurück zum Zitat Redwine DB, Koning M, Sharpe DR (1996) Laparoscopically assisted transvaginal segmental resection of the rectosigmoid colon for endometriosis. Fertil Steril 65(1):193–197PubMed Redwine DB, Koning M, Sharpe DR (1996) Laparoscopically assisted transvaginal segmental resection of the rectosigmoid colon for endometriosis. Fertil Steril 65(1):193–197PubMed
16.
Zurück zum Zitat Langebrekke A et al (2006) Endoscopic treatment of deep infiltrating endometriosis (DIE) involving the bladder and rectosigmoid colon. Acta Obstet Gynecol Scand 85(6):712–715PubMedCrossRef Langebrekke A et al (2006) Endoscopic treatment of deep infiltrating endometriosis (DIE) involving the bladder and rectosigmoid colon. Acta Obstet Gynecol Scand 85(6):712–715PubMedCrossRef
17.
Zurück zum Zitat Lyons SD et al (2006) Clinical and quality-of-life outcomes after fertility-sparing laparoscopic surgery with bowel resection for severe endometriosis. J Minim Invasive Gynecol 13(5):436–441PubMedCrossRef Lyons SD et al (2006) Clinical and quality-of-life outcomes after fertility-sparing laparoscopic surgery with bowel resection for severe endometriosis. J Minim Invasive Gynecol 13(5):436–441PubMedCrossRef
18.
Zurück zum Zitat Brouwer R, Woods RJ (2007) Rectal endometriosis: results of radical excision and review of published work. ANZ J Surg 77(7):562–571PubMedCrossRef Brouwer R, Woods RJ (2007) Rectal endometriosis: results of radical excision and review of published work. ANZ J Surg 77(7):562–571PubMedCrossRef
19.
Zurück zum Zitat Ribeiro PA et al (2006) Laparoscopic resection of intestinal endometriosis: a 5-year experience. J Minim Invasive Gynecol 13(5):442–446PubMedCrossRef Ribeiro PA et al (2006) Laparoscopic resection of intestinal endometriosis: a 5-year experience. J Minim Invasive Gynecol 13(5):442–446PubMedCrossRef
20.
Zurück zum Zitat Deffieux X et al Voiding dysfunction after surgical resection of deeply infiltrating endometriosis: pathophysiology and management. Gynecol Obstet Fertil 35(Suppl 1):S8–S13 Deffieux X et al Voiding dysfunction after surgical resection of deeply infiltrating endometriosis: pathophysiology and management. Gynecol Obstet Fertil 35(Suppl 1):S8–S13
21.
Zurück zum Zitat Kavallaris A et al (2010) 94 months follow-up after laparoscopic assisted vaginal resection of septum rectovaginale and rectosigmoid in women with deep infiltrating endometriosis. Arch Gynecol Obstet Kavallaris A et al (2010) 94 months follow-up after laparoscopic assisted vaginal resection of septum rectovaginale and rectosigmoid in women with deep infiltrating endometriosis. Arch Gynecol Obstet
22.
Zurück zum Zitat Crosignani PG et al (1996) Laparoscopy versus laparotomy in conservative surgical treatment for severe endometriosis. Fertil Steril 66(5):706–711PubMed Crosignani PG et al (1996) Laparoscopy versus laparotomy in conservative surgical treatment for severe endometriosis. Fertil Steril 66(5):706–711PubMed
23.
Zurück zum Zitat Possover M et al (2000) Identification and preservation of the motoric innervation of the bladder in radical hysterectomy type III. Gynecol Oncol 79(2):154–157PubMedCrossRef Possover M et al (2000) Identification and preservation of the motoric innervation of the bladder in radical hysterectomy type III. Gynecol Oncol 79(2):154–157PubMedCrossRef
24.
Zurück zum Zitat Volpi E, Ferrero A, Sismondi P (2004) Laparoscopic identification of pelvic nerves in patients with deep infiltrating endometriosis. Surg Endosc 18(7):1109–1112PubMedCrossRef Volpi E, Ferrero A, Sismondi P (2004) Laparoscopic identification of pelvic nerves in patients with deep infiltrating endometriosis. Surg Endosc 18(7):1109–1112PubMedCrossRef
25.
Zurück zum Zitat Dubernard G et al (2008) Urinary complications after surgery for posterior deep infiltrating endometriosis are related to the extent of dissection and to uterosacral ligaments resection. J Minim Invasive Gynecol 15(2):235–240PubMedCrossRef Dubernard G et al (2008) Urinary complications after surgery for posterior deep infiltrating endometriosis are related to the extent of dissection and to uterosacral ligaments resection. J Minim Invasive Gynecol 15(2):235–240PubMedCrossRef
26.
Zurück zum Zitat Minelli L, Ceccaroni M, Ruffo G, Bruni F, Pomini P, Pontrelli G, Rolla M, Scioscia M (2010) Laparoscopic conservative surgery for stage IV symptomatic endometriosis: short-term surgical complications. Fertil Steril 94(4):1218–1222 Minelli L, Ceccaroni M, Ruffo G, Bruni F, Pomini P, Pontrelli G, Rolla M, Scioscia M (2010) Laparoscopic conservative surgery for stage IV symptomatic endometriosis: short-term surgical complications. Fertil Steril 94(4):1218–1222
27.
Zurück zum Zitat Landi S et al (2006) Laparoscopic nerve-sparing complete excision of deep endometriosis: is it feasible? Hum Reprod 21(3):774–781PubMedCrossRef Landi S et al (2006) Laparoscopic nerve-sparing complete excision of deep endometriosis: is it feasible? Hum Reprod 21(3):774–781PubMedCrossRef
28.
Zurück zum Zitat Dubernard G et al (2006) Quality of life after laparoscopic colorectal resection for endometriosis. Hum Reprod 21(5):1243–1247PubMedCrossRef Dubernard G et al (2006) Quality of life after laparoscopic colorectal resection for endometriosis. Hum Reprod 21(5):1243–1247PubMedCrossRef
29.
Zurück zum Zitat Granese R et al (2008) Bladder endometriosis: laparoscopic treatment and follow-up. Eur J Obstet Gynecol Reprod Biol 140(1):114–117PubMedCrossRef Granese R et al (2008) Bladder endometriosis: laparoscopic treatment and follow-up. Eur J Obstet Gynecol Reprod Biol 140(1):114–117PubMedCrossRef
30.
Zurück zum Zitat Seracchioli R et al (2007) Surgical outcome and long-term follow up after laparoscopic rectosigmoid resection in women with deep infiltrating endometriosis. BJOG 114(7):889–895PubMedCrossRef Seracchioli R et al (2007) Surgical outcome and long-term follow up after laparoscopic rectosigmoid resection in women with deep infiltrating endometriosis. BJOG 114(7):889–895PubMedCrossRef
31.
Zurück zum Zitat Minelli L et al (2010) Laparoscopic conservative surgery for stage IV symptomatic endometriosis: short-term surgical complications. Fertil Steril 94(4):1218–1222PubMedCrossRef Minelli L et al (2010) Laparoscopic conservative surgery for stage IV symptomatic endometriosis: short-term surgical complications. Fertil Steril 94(4):1218–1222PubMedCrossRef
32.
Zurück zum Zitat Darai E et al (2005) Feasibility and clinical outcome of laparoscopic colorectal resection for endometriosis. Am J Obstet Gynecol 192(2):394–400PubMedCrossRef Darai E et al (2005) Feasibility and clinical outcome of laparoscopic colorectal resection for endometriosis. Am J Obstet Gynecol 192(2):394–400PubMedCrossRef
33.
Zurück zum Zitat Fanfani F et al (2010) Discoid or segmental rectosigmoid resection for deep infiltrating endometriosis: a case–control study. Fertil Steril 94(2):444–449PubMedCrossRef Fanfani F et al (2010) Discoid or segmental rectosigmoid resection for deep infiltrating endometriosis: a case–control study. Fertil Steril 94(2):444–449PubMedCrossRef
34.
Zurück zum Zitat Frenna V et al (2007) Laparoscopic management of ureteral endometriosis: our experience. J Minim Invasive Gynecol 14(2):169–171PubMedCrossRef Frenna V et al (2007) Laparoscopic management of ureteral endometriosis: our experience. J Minim Invasive Gynecol 14(2):169–171PubMedCrossRef
35.
Zurück zum Zitat Kavallaris A et al (2010) Laparoscopic nerve-sparing surgery of deep infiltrating endometriosis: description of the technique and patients’ outcome. Arch Gynecol Obstet Kavallaris A et al (2010) Laparoscopic nerve-sparing surgery of deep infiltrating endometriosis: description of the technique and patients’ outcome. Arch Gynecol Obstet
36.
Zurück zum Zitat Possover M et al (2007) Laparoscopic neurolysis of the sacral plexus and the sciatic nerve for extensive endometriosis of the pelvic wall. Minim Invasive Neurosurg 50(1):33–36PubMedCrossRef Possover M et al (2007) Laparoscopic neurolysis of the sacral plexus and the sciatic nerve for extensive endometriosis of the pelvic wall. Minim Invasive Neurosurg 50(1):33–36PubMedCrossRef
37.
Zurück zum Zitat Abbott JA et al (2003) The effects and effectiveness of laparoscopic excision of endometriosis: a prospective study with 2–5 year follow-up. Hum Reprod 18(9):1922–1927PubMedCrossRef Abbott JA et al (2003) The effects and effectiveness of laparoscopic excision of endometriosis: a prospective study with 2–5 year follow-up. Hum Reprod 18(9):1922–1927PubMedCrossRef
38.
Zurück zum Zitat Donnez J, Nisolle M (1995) Advanced laparoscopic surgery for the removal of rectovaginal septum endometriotic or adenomyotic nodules. Baillieres Clin Obstet Gynaecol 9(4):769–774PubMedCrossRef Donnez J, Nisolle M (1995) Advanced laparoscopic surgery for the removal of rectovaginal septum endometriotic or adenomyotic nodules. Baillieres Clin Obstet Gynaecol 9(4):769–774PubMedCrossRef
39.
Zurück zum Zitat Possover M, Chiantera V (2009) Neuromodulation of the superior hypogastric plexus: a new option to treat bladder atonia secondary to radical pelvic surgery? Surg Neurol 72(6):573–576PubMedCrossRef Possover M, Chiantera V (2009) Neuromodulation of the superior hypogastric plexus: a new option to treat bladder atonia secondary to radical pelvic surgery? Surg Neurol 72(6):573–576PubMedCrossRef
40.
Zurück zum Zitat Chapron C, Dubuisson JB (1996) Laparoscopic treatment of deep endometriosis located on the uterosacral ligaments. Hum Reprod 11(4):868–873PubMed Chapron C, Dubuisson JB (1996) Laparoscopic treatment of deep endometriosis located on the uterosacral ligaments. Hum Reprod 11(4):868–873PubMed
41.
Zurück zum Zitat Koninckx PR et al (1996) Complications of CO2-laser endoscopic excision of deep endometriosis. Hum Reprod 11(10):2263–2268PubMed Koninckx PR et al (1996) Complications of CO2-laser endoscopic excision of deep endometriosis. Hum Reprod 11(10):2263–2268PubMed
42.
Zurück zum Zitat Benbara A et al (2008) Surgical and functional results of rectosigmoidal resection for severe endometriosis. Gynecol Obstet Fertil 36(12):1191–1201PubMedCrossRef Benbara A et al (2008) Surgical and functional results of rectosigmoidal resection for severe endometriosis. Gynecol Obstet Fertil 36(12):1191–1201PubMedCrossRef
43.
Zurück zum Zitat Ceccaroni M et al (2010) Nerve-sparing laparoscopic radical excision of deep endometriosis with rectal and parametrial resection. J Minim Invasive Gynecol 17(1):14–15PubMedCrossRef Ceccaroni M et al (2010) Nerve-sparing laparoscopic radical excision of deep endometriosis with rectal and parametrial resection. J Minim Invasive Gynecol 17(1):14–15PubMedCrossRef
44.
Zurück zum Zitat Tuttlies F, Keckstein J, Ulrich U, Possover M, Schweppe KW, Wustlich M, Buchweitz O, Greb R, Kandolf O, Mangold R, Masetti W, Neis K, Rauter G, Reeka N, Richter O, Schindler AE, Sillem M, Terruhn V, Tinneberg HR (2005) ENZIAN-score, a classification of deep infiltrating endometriosis. Zentralbl Gynakol 127:275–281PubMedCrossRef Tuttlies F, Keckstein J, Ulrich U, Possover M, Schweppe KW, Wustlich M, Buchweitz O, Greb R, Kandolf O, Mangold R, Masetti W, Neis K, Rauter G, Reeka N, Richter O, Schindler AE, Sillem M, Terruhn V, Tinneberg HR (2005) ENZIAN-score, a classification of deep infiltrating endometriosis. Zentralbl Gynakol 127:275–281PubMedCrossRef
Metadaten
Titel
Follow-up of dysfunctional bladder and rectum after surgery of a deep infiltrating rectovaginal endometriosis
verfasst von
A. Kavallaris
I. Mebes
D. Evagyelinos
A. Dafopoulos
D. A. Beyer
Publikationsdatum
01.05.2011
Verlag
Springer-Verlag
Erschienen in
Archives of Gynecology and Obstetrics / Ausgabe 5/2011
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-010-1833-2

Weitere Artikel der Ausgabe 5/2011

Archives of Gynecology and Obstetrics 5/2011 Zur Ausgabe

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.