Pelvic organ function before and after laparoscopic bowel resection for rectosigmoid endometriosis: a prospective, observational study

ObjectiveTo assess urinary, sexual, and bowel function before and after laparoscopic bowel resection for rectosigmoid endometriosis. DesignProspectively collected data regarding the function of the pelvic organs. SettingTertiary endometriosis referral unit, Aarhus University Hospital. SampleA cohort of 128 patients who underwent laparoscopic bowel resection for endometriosis. MethodsThe International Consultation on Incontinence Questionnaire (ICIQ), Sexual Function-Vaginal Changes Questionnaire (SVQ), and the Low Anterior Resection Syndrome (LARS) questionnaire were answered before and after surgery. Non-invasive urodynamic testing was performed. Main outcome measuresPre- and postoperative function of the pelvic organs was compared, and risk factors for improved/impaired function were identified. ResultsA total of 96.1% of the women completed the 1-year follow-up. A significant decrease (P=0.002) in bladder filling problems (F-score) was observed 1year after surgery, primarily caused by a significant decrease in bladder pain (P=0.0001). No change for urodynamic parameters was observed. A significant increase in overall sexual satisfaction (P=0.0001) and decrease in worries about sexual life (P=0.001) was seen 1year after surgery. Frequency of defecation was significantly increased 1year after surgery (P=0.0001), but the overall bowel function measured by LARS score was unchanged. Patients with anastomotic leakage had a significantly higher risk (odds ratio, OR5.40; P=0.002) of increased incontinence problems (I-score) 1year after surgery. ConclusionA significant and clinically relevant improvement in urinary and sexual function 1year after laparoscopic bowel resection for endometriosis was found. Except for anastomotic leakage, this could be observed independent of any patient- or treatment-related factor. Apprehension about impairment of urinary and sexual function should not be a contraindication for bowel resection in endometriosis patients. Tweetable abstractRectal resection for endometriosis does not impair urinary and sexual function 1year after surgery. Tweetable abstract Rectal resection for endometriosis does not impair urinary and sexual function 1year after surgery.