Department of Gynecology, Hospital do Servidor Público Estadual de São Paulo, Pedro de Toledo Street, 1800, São Paulo, Vila Clementino, CEP 04039-004, Brazil.
Department of Advanced Medical and Surgical Sciences, Università Studi della Campania "Luigi Vanvitelli", Naples, Italy.
Langenbecks Arch Surg. 2023 Feb 11;408(1):83. doi: 10.1007/s00423-023-02831-6.
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.
Prospective, observational study.
single-center, referral hospital for endometriosis. Patients undergoing laparoscopic surgery for deep-infiltrating endometriosis of the rectosigmoid colon between October 2016 and October 2018.
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.
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).
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.
本研究旨在评估腹腔镜手术治疗直肠乙状结肠深部浸润性子宫内膜异位症后下尿路症状的发生率和进展情况，并确定与术后不良结局相关的术前因素。
前瞻性、观察性研究。
单中心，子宫内膜异位症转诊医院。2016 年 10 月至 2018 年 10 月期间，对接受腹腔镜手术治疗直肠乙状结肠深部浸润性子宫内膜异位症的患者进行研究。
采用经过验证的葡萄牙语版国际前列腺症状评分（也用于女性）评估尿功能，该评分在术前和术后进行收集。采用 Wilcoxon 符号秩检验比较术前和术后评分，采用卡方检验比较按严重程度分类的症状。
共评估了 53 例患者，其中 44 例纳入研究。关于术后的尿路症状，刺激症状比阻塞症状更为常见。此外，分别有 58.8%和 54.5%的女性在术前和术后报告有中度或重度症状。在至少一个问卷类别中，有 10 名（22.7%）参与者的术后问卷评分增加。在从无/轻度到中度/重度国际前列腺症状评分（IPSS）类别的变化比较中，差异具有统计学意义（P=0.039）。术前和术后任何国际前列腺症状评分均未发生显著变化（P=0.876）。
术前和术后均存在较高的尿路症状发生率。术前存在中重度国际前列腺症状评分的患者，在接受直肠乙状结肠深部子宫内膜异位症腹腔镜手术后，存在持续尿功能障碍的风险。
