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结直肠子宫内膜异位症切除术后的尿功能障碍:腹腔镜与开腹手术比较的前瞻性随机试验结果。

Urinary dysfunction after colorectal resection for endometriosis: results of a prospective randomized trial comparing laparoscopy to open surgery.

机构信息

Department of Gynecology and Obstetrics, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, CancerEst, Université Pierre et Marie Curie, Paris, France.

出版信息

Am J Obstet Gynecol. 2011 Apr;204(4):303.e1-6. doi: 10.1016/j.ajog.2010.11.011. Epub 2011 Jan 21.

Abstract

OBJECTIVE

To evaluate urinary symptoms before and after colorectal resection for endometriosis using validated questionnaires.

STUDY DESIGN

We randomly assigned 52 patients with colorectal endometriosis to undergo laparoscopically assisted or open colorectal resection. The median follow-up was 19 months. Urinary symptoms were evaluated using the International Prostate Score Symptom and the Bristol Female Low Urinary Tract Symptoms questionnaires.

RESULTS

Dysuria was observed in 29% of cases postoperatively. Using Bristol Female Low Urinary Tract Symptoms and International Prostate Score Symptom scores, an alteration was observed for voiding symptoms (P = .01 and P = .006, respectively). No difference was observed between the laparoscopy and the open surgery group. An alteration of the International Prostate Score Symptom voiding symptoms was observed in the group that did not undergo nerve sparing surgery (P = .048). An alteration of the International Prostate Score Symptom voiding symptoms was observed for patients who underwent vaginal resection (P = .01) and parametrial resection (P = .02).

CONCLUSION

Our findings confirm that colorectal resection for endometriosis is a source of urinary dysfunction whatever the surgical route.

摘要

目的

使用经过验证的问卷评估子宫内膜异位症结直肠切除前后的尿症状。

研究设计

我们随机分配 52 例结直肠子宫内膜异位症患者行腹腔镜辅助或开放结直肠切除术。中位随访时间为 19 个月。使用国际前列腺评分症状问卷和布里斯托女性下尿路症状问卷评估尿症状。

结果

术后有 29%的患者出现排尿困难。使用布里斯托女性下尿路症状问卷和国际前列腺评分症状问卷评分,排尿症状发生变化(P=.01 和 P=.006,分别)。腹腔镜组和开放手术组之间无差异。未行神经保留手术的患者国际前列腺评分症状排尿症状发生变化(P=.048)。行阴道切除术(P=.01)和子宫旁切除术(P=.02)的患者国际前列腺评分症状排尿症状发生变化。

结论

我们的研究结果证实,无论手术途径如何,结直肠切除术治疗子宫内膜异位症都会导致尿功能障碍。

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