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Partial Colpectomy is a Risk Factor for Urologic Complications of Colorectal Resection for Endometriosis
Authors:Sonia Zilberman  Marcos Ballester  Cyril Touboul  Elisabeth Chéreau  Philippe Sèbe  Marc Bazot  Emile Daraï
Affiliation:1. Service de Gynécologie-Obstétrique, Hôpital Tenon, Paris, France;2. Service d’Urologie, Hôpital Tenon, Paris, France;3. Service de Radiologie, Hôpital Tenon, Paris, France
Abstract:
Study ObjectiveTo evaluate urologic complications after colorectal resection for endometriosis.DesignCohort study (Canadian Task Force classification II-2).SettingTertiary referral university hospital and expert center in endometriosis.PatientsOne hundred sixty-six women with colorectal endometriosis proven by transvaginal sonography and magnetic resonance imaging.InterventionOpen or laparoscopic colorectal resection for endometriosis.Measurements and Main ResultsForty-four patients (26.5%) experienced at least 1 urologic complication, including infection. Eight patients (4.8%) experienced postoperative symptomatic hydronephrosis requiring ureteral stent in 3 cases, a percutaneous nephrostomy in 1 case, and expectant management for the last 4. Urologic fistulas occurred in 5 patients (3%). Postoperative voiding dysfunction requiring self-catheterization was observed in 48 patients (28.9%). With univariate analysis, a relationship was found between voiding dysfunction and partial colpectomy (p = .001) and American Society of Reproductive Medicine total score (p = .02), and between the occurrence of urinary fistula and the use of prophylactic ureteral catheterization (p = .015) and parametrectomy (p = .02). A relationship was found between postoperative symptomatic hydronephrosis and the use of prophylactic ureteral catheterization (p = .003).ConclusionColorectal resection for endometriosis can lead to urologic complications, particularly for patients requiring partial colpectomy, of which patients need to be informed.
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