Evaluation of urinary dysfunction by urodynamic tests, electromyography and quality of life questionnaire before and after surgery for deep infiltrating endometriosis

Objective: To evaluate urinary dysfunction and quality of life before and after surgery for deep infiltrating endometriosis (DIE). Methods: This prospective study included 50 patients with DIE who required surgery. Urinary dysfunction was evaluated before and after surgery by both urodynamic tests and electromyography, and the Bristol Female Lower Urinary Tract Symptoms (BFLUTS) quality-of-life questionnaire. Results: Preoperative electromyography showed that 14 patients (28%) had neurogenic alteration involving sacral reflex and pelvic floor muscles correlated with the presence of colorectal endometriosis (p=0.003). Postoperative quality of life and BFLUTS total scores were improved compared to preoperative scores (p = 0.001 and p = 0.005, respectively). After an initial improvement in BFLUTS, an alteration is observed at long-term (median follow-up of 66 months). In the 34 patients with pre- and postoperative urodynamic measurements, no difference was found before and after surgery. De novo peripheral neuropathy was only observed in patients who underwent DIE resection with colorectal resection (p = 0.02). Conclusions: Our results support that patients with DIE have a high incidence of preoperative urinary symptoms and neurogenic dysfunction. Colorectal resection appears to be a determinant factor of de novo peripheral neuropathy. (C) 2014 Elsevier Ireland Ltd. All rights reserved.