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Partial colpectomy is a risk factor for urologic complications of colorectal resection for endometriosis
Sonia Zilberman1, Marcos Ballester, Cyril Touboul
1Service de Gynécologie-Obstétrique, Hôpital Tenon, Paris, France.
Study Objective:
To evaluate urologic complications after colorectal resection for endometriosis.
Design:
Cohort study (Canadian Task Force classification II-2).
Setting:
Tertiary referral university hospital and expert center in endometriosis.
Patients:
One hundred sixty-six women with colorectal endometriosis proven by transvaginal sonography and magnetic resonance imaging.
Intervention:
Open or laparoscopic colorectal resection for endometriosis.
Measurements And Main Results:
Forty-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).
Conclusion:
Colorectal 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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