Division of General Gynecology and Gynecologic Oncology, Department of Obstetrics and Gynecology, Medical University of Vienna, Austria; Karl Landsteiner Society for Special Gynecology and Obstetrics, Vienna, Austria.
Department of Obstetrics and Gynecology, University of Verona, Italy; Department of Obstetrics and Gynecology, Insubria University, Varese, Italy.
J Minim Invasive Gynecol. 2022 Apr;29(4):567-575. doi: 10.1016/j.jmig.2021.12.017. Epub 2022 Jan 2.
To assess whether deep endometriosis surgery affects the bladder function.
Prospective multicenter observational study (Canadian Task Force classification II-2).
Academic research centers.
Thirty-two patients with diagnosis of deep endometriosis requiring surgery.
Women were evaluated with urodynamic studies, International Consultation on Incontinence Questionnaire - Urinary Incontinence Short Form, and International Consultation on Incontinence Questionnaire Overactive Bladder Module questionnaires before and 3 months after surgery.
The main outcome measure was the impact of deep endometriosis surgery on urodynamic parameters. All cystomanometric parameters showed an improvement postoperatively: in particular, the first desire to void (120 vs 204 mL; p <.001) and the bladder capacity (358 vs 409 mL; p = .011) increased significantly after surgery. Of the uroflow parameters, the maximal voiding flow improved significantly postoperatively (19 vs 25 mL/s; p = .026). The International Consultation on Incontinence Questionnaire - Urinary Incontinence Short Form (2.5 vs 0; p = .0005) and International Consultation on Incontinence Questionnaire Overactive Bladder Module (4.3 vs 1.2; p <.001) questionnaires showed a significant postoperative improvement too.
Our data show that in a selected population of patients with deep infiltrating endometriosis (not requiring bowel or ureteral resection), the bladder function improves after surgery, both during filling and on voiding urodynamic phases. Postoperatively, patients with deep infiltrating endometriosis become aware of bladder filling later, have a higher bladder capacity, and have a higher maximal flow. The postoperative urodynamic results are corroborated by the improved scores on the bladder questionnaires.
评估深部子宫内膜异位症手术是否会影响膀胱功能。
前瞻性多中心观察性研究（加拿大任务组分类 II-2）。
学术研究中心。
32 名诊断为深部子宫内膜异位症且需要手术的患者。
在手术前和手术后 3 个月，女性接受尿动力学研究、国际尿失禁咨询问卷-尿失禁简短表和国际尿失禁咨询问卷-膀胱过度活动症模块问卷评估。
主要结局指标是深部子宫内膜异位症手术对尿动力学参数的影响。所有膀胱测压参数在术后均显示出改善：特别是首次排尿欲望（120 比 204 毫升；p<0.001）和膀胱容量（358 比 409 毫升；p=0.011）显著增加。在尿流参数中，最大排尿流量在术后显著改善（19 比 25 毫升/秒；p=0.026）。国际尿失禁咨询问卷-尿失禁简短表（2.5 比 0；p=0.0005）和国际尿失禁咨询问卷-膀胱过度活动症模块（4.3 比 1.2；p<0.001）问卷在术后也显示出显著改善。
我们的数据表明，在深部浸润性子宫内膜异位症（不需要肠或输尿管切除）的选定患者人群中，膀胱功能在手术后无论是在充盈期还是排尿期都得到了改善。手术后，深部浸润性子宫内膜异位症患者对膀胱充盈的感知延迟，膀胱容量增加，最大流量增加。术后尿动力学结果得到膀胱问卷评分改善的支持。
