Predictive Factors for Voiding Dysfunction after Surgery for Deep Infiltrating Endometriosis

Imboden, Sara; Bollinger, Yaelle; Härmä, Kirsi Hannele; Knabben, Laura; Fluri, Mihaela; Nirgianakis, Konstantinos; Mohr, Stefan; Kühn, Annette; Mueller, Michael D.

doi:10.1016/j.jmig.2021.01.009

Cited by 17 publications

(6 citation statements)

References 18 publications

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“…22 Furthermore, this rate has been more recently reported to be as high as 50% by others. 23 The rate of temporary protective ileostomy in our study was 3.64%, which is lower than previous reports. Indeed, in a national snapshot of the surgical management of deep in ltrating endometriosis of the rectum and colon in France in 2015, Roman et al reported a protective stoma rate of 19%.…”

Section: Discussioncontrasting

confidence: 78%

Clinical outcomes following surgical management of deep infiltrating endometriosis: a retrospective cohort study

LEBORNE,

HUBERLANT,

MASIA

et al. 2022

Preprint

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Objectives: The main aim of the study was to evaluate severe post-operative complications following deep endometriosis surgery in a tertiary referral centre.Methods: This is a retrospective cohort study that included women who had surgery for deep infiltrating endometriosis between 1st January 2013 and 31st December 2019. Endometriosis was diagnosed based on clinical, imaging and histological parameters. We evaluated the rates of post-operative complications, potential risk factors for such complications and postoperative pregnancy rates.Results: A total of 165 patients were included in the final analysis. The median follow-up was 63 (25 - 106) months. Thirty-seven patients (22.42%) had hysterectomy, 60 (36.81%) had ureterolysis and 44 (26.67%) had colorectal surgery. The overall and severe rates of post-operative complications were 16.20% (n=23) and 2.42% (n=4) respectively. Of the variables assessed, operative time and age were the only statistically significant risk factor for complications on multivariate analysis. Among the women operated on for infertility, 34.5% (n=20/58) got pregnant following surgery with 30% of these spontaneously.Conclusions: This study demonstrates acceptable overall and severe post-operative complications and pregnancy rates after deep endometriosis surgery. This information should help clinicians when counselling women to enable them make an informed choice about their management.

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Section: Discussioncontrasting

confidence: 78%

Clinical outcomes following surgical management of deep infiltrating endometriosis: a retrospective cohort study

LEBORNE,

HUBERLANT,

MASIA

et al. 2022

Preprint

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“…The risk of surgical complications was lowest in the low-risk group and highest in the high-risk group. Imboden et al ( 2021 ) reported a higher risk of postoperative voiding dysfunction in patients with DE involving the B compartment, especially for B3 lesions. Finally, Nicolaus et al ( 2020 ) found a statistically significant 3.5-fold increased risk of Clavien-Dindo complications grade II or higher in the presence DE in the Enzian score.…”

Section: The Enzian and (#) Enzian Classificationsmentioning

confidence: 99%

What to choose and why to use – a critical review on the clinical relevance of rASRM, EFI and Enzian classifications of endometriosis

Hudelist¹,

Valentin²,

Sarıdoğan³

et al. 2021

Facts Views Vis ObGyn

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Background: Endometriosis is a common benign gynaecological disease that affects pelvic structures and causes adhesions. Endometriosis outside the pelvis exists but is rarer. Deep endometriosis may affect organs such as the urinary bladder, ureters, bowel and sacral roots. Adenomyosis (growth of endometrium in the myometrium, sometimes explained by disruption of the uterine junctional zone) frequently co-exists with deep endometriosis. Over the past decades, multiple attempts have been made to describe the anatomical extent of endometriosis. Out of approximately 20 classification systems suggested and published so far, three have gained widespread acceptance. These are the rASRM (American Society of Reproductive Medicine) classification, the Endometriosis Fertility Index (EFI) and the Enzian classification. Ideally, a classification system should be useful both for describing disease extent based on surgical findings and results of imaging methods (ultrasound, magnetic resonance imaging). Objectives: To highlight the advantages and disadvantages of the three classification systems. Methods: This is a narrative review based on selected publications and experience of the authors. We discuss the current literature on the use of the rASRM, EFI and Enzian classification systems for describing disease extent with imaging methods and for prediction of fertility, surgical complexity, and risk of surgical complications. We underline the need for one universally acceptable terminology to describe the extent of endometriosis. Conclusions: A useful classification system for endometriosis should describe the sites and extent of the disease, be related to surgical complexity and to disease-associated symptoms, including subfertility and should satisfy needs of both, imaging specialists for pre-operative classification and surgeons. The need for such a system is obvious and is provided by the #Enzian classification. Future research is necessary to test its validity.

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“…In a comprehensive literature review, Campin et al reported varying risk of post-operative voiding dysfunction ranging from 0.8 to 30% 21 . Furthermore, this rate has been more recently reported to be as high as 50% by others 22 .…”

Section: Discussionmentioning

confidence: 81%

Clinical outcomes following surgical management of deep infiltrating endometriosis

Leborne

Huberlant

Masia

et al. 2022

Sci Rep

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The main aim of the study was to evaluate severe post-operative complications following deep endometriosis surgery in a tertiary referral centre. This is a retrospective cohort study that included women who had surgery for deep infiltrating endometriosis between 1st January 2013 and 31st December 2019. Endometriosis was diagnosed based on clinical, imaging and histological parameters. We evaluated the rates of post-operative complications, potential risk factors for such complications and postoperative pregnancy rates. A total of 165 patients were included in the final analysis. The median follow-up was 63 (25–106) months. Thirty-seven patients (22.42%) had hysterectomy, 60 (36.81%) had ureterolysis and 44 (26.67%) had colorectal surgery. The overall and severe rates of post-operative complications were 16.20% (n = 23) and 2.42% (n = 4) respectively. Of the variables assessed, operative time and age were the only statistically significant risk factor for complications on multivariate analysis. Among women operated on for infertility, 34.5% (n = 20/58) got pregnant following surgery with 30% of these spontaneously. This study demonstrates acceptable overall and severe post-operative complications and pregnancy rates after deep endometriosis surgery. This information should help clinicians when counselling women to enable them making an informed choice about their management.

show abstract

Predictive Factors for Voiding Dysfunction after Surgery for Deep Infiltrating Endometriosis

Cited by 17 publications

References 18 publications

Clinical outcomes following surgical management of deep infiltrating endometriosis: a retrospective cohort study

Clinical outcomes following surgical management of deep infiltrating endometriosis: a retrospective cohort study

What to choose and why to use – a critical review on the clinical relevance of rASRM, EFI and Enzian classifications of endometriosis

Clinical outcomes following surgical management of deep infiltrating endometriosis

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