Predictive Factors for Voiding Dysfunction after Surgery for Deep Infiltrating Endometriosis.

Imboden, Sara; Bollinger, Yaelle; Härmä, Kirsi; Knabben, Laura; Fluri, Mihaela; Nirgianakis, Konstantinos; Mohr, Stefan; Kuhn, Annette; Mueller, Michael D. (2021). Predictive Factors for Voiding Dysfunction after Surgery for Deep Infiltrating Endometriosis. Journal of minimally invasive gynecology, 28(8), pp. 1544-1551. Elsevier 10.1016/j.jmig.2021.01.009

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STUDY OBJECTIVE

To evaluate the prognostic value of pre- and perioperative factors for voiding dysfunction after surgery for deep infiltrating endometriosis (DIE).

DESIGN

Single-center retrospective cohort study.

SETTING

University hospital.

PATIENTS

A total of 198 women with DIE in the posterior compartment who underwent surgery and a postoperative bladder scan.

INTERVENTIONS

Surgical resection of the DIE nodule from the dorsal compartment.

MEASUREMENTS AND MAIN RESULTS

After surgery, 41% of the patients initially experienced voiding dysfunction (defined as >100 mL postvoid residual urine volume at second bladder scan). The number decreased to 11% by the time of hospital discharge. Among those with a need for self-catheterization after discharge (n = 17), voiding dysfunction lasted for a median of 41 days before a return to normal bladder function, with a residual urine volume of <100 mL. The preoperative presence of DIE nodules in the ENZIAN compartment B was associated with postoperative voiding dysfunction (p = .001). The hazard ratio for elevated residual urine volume was highest when the disease stage was B3 (hazard ratio 6.43; CI, 2.3-18.2; p <.001), describing a nodule diameter of >3 cm in lateral distension. Receiver operating characteristic curve analyses showed that a first residual urine volume >220 mL has a good predictive value for the risk of intermittent self-catheterization (area under the receiver operating characteristic curve 0.893; p <.001).

CONCLUSION

Postoperative voiding dysfunction is frequent; of note, in most cases the problem is temporary. When DIE with an ENZIAN classification B is noted intraoperatively and, most of all, when the diameter of the lesion is >3 cm, a higher risk of postoperative voiding dysfunction is to be expected.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Gynaecology

UniBE Contributor:

Imboden, Sara, Knabben, Laura Michelle Tatjana, Fluri, Mihaela-Madalina, Nirgianakis, Konstantinos, Mohr, Stefan, Kuhn, Annette, Mueller, Michael

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1553-4650

Publisher:

Elsevier

Language:

English

Submitter:

Monika Zehr

Date Deposited:

03 Jan 2022 12:05

Last Modified:

05 Dec 2022 16:00

Publisher DOI:

10.1016/j.jmig.2021.01.009

PubMed ID:

33476749

Uncontrolled Keywords:

Deep infiltrating endometriosis ENZIAN classification Postoperative urinary voiding dysfunction Surgery

BORIS DOI:

10.48350/163605

URI:

https://boris.unibe.ch/id/eprint/163605

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