Deep endometriosis and bladder and detrusor functions in women without urinary symptoms A pilot study through an unexplored world

Capsule:
Deep endometriosis may impair visceral and motor function owing to fibrotic neural involvement. Our pilot study seems to showthatdetrusor function could be significantly compromised, even in asymptomatic women.

Authors:
Maurizio Serati, M.D., Elena Cattoni, M.D., Andrea Braga, M.D., Stefano Uccella, M.D., Antonella Cromi, M.D., Fabio Ghezzi, M.D.

Volume 100, Issue 5, Pages 1332-1336, November 2013

Abstract:

Objective:
To evaluate the impact of deep endometriosis (DE) on bladder function, focusing on detrusor pattern, in patients without preoperative urinary symptoms.

Design:
Prospective study.

Setting:
Academic research center.

Patient(s):
A total of 25 asymptomatic patients: 12 patients with DE (group 1) and 13 patients with ovarian endometriosis (group 2, control group).

Intervention(s):
Preoperative urodynamic evaluation.

Main Outcome Measure(s):
The impact of DE on urodynamic parameters.

Result(s):
For the first time, a urodynamic diagnosis of detrusor overactivity was correlated with the presence of deep infiltrating endometriosis (group 1, 91.7% [11/12] vs. group 2, 7.7% [1/13]). All involuntary detrusor contractions were detected only during the filling phase. All cystometry parameters were found to be altered in group 1 and statistically different between the two groups. No pressure/flow study parameter significantly differed between the two groups, besides maximal detrusor pressure (46 cmH2O [33–79] vs. 29 cmH2O [15–40]), which was significantly higher in group 1. Therefore, all detrusor-related parameters are statistically different between the two groups. Postvoid residual does not reach a statistically significant difference.

Conclusion(s):
DE could significantly impair detrusor functions. A preoperative urodynamic evaluation allows the attainment of important functional information, even in asymptomatic patients.

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