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VOIDING DYSFUNCTION AFTER ROBOTIC-ASSISTED LAPAROSCOPIC SURGERY FOR COLORECTAL ENDOMETRIOSIS: A SYSTEMACTIC REVIEW
Alexandra Madar1, Clément Ferrier1, Yohan Dabi1
1Department of Gynecology and Obstetrics, Medicine of the Reproduction, Tenon University Hospital, 4, rue de la Chine, 75020 Paris, Assistance Publique des Hôpitaux de Paris, Sorbonne University, Paris, France.
Robotic-assisted laparoscopic surgery (RALS) significantly reduces the risk of voiding dysfunction (VD) after deep infiltrating endometriosis (DIE) surgery compared to conventional laparoscopy (CL). RALS is recommended for patients with high VD risk during DIE surgery.
Area of Science:
- Gynecology
- Urology
- Surgical Oncology
Background:
- Deep infiltrating endometriosis (DIE) with colorectal involvement poses surgical challenges.
- Voiding dysfunction (VD) is a potential postoperative complication following DIE surgery.
- Comparing surgical approaches is crucial for optimizing patient outcomes.
Purpose of the Study:
- To determine the incidence of VD after colorectal DIE surgery.
- To compare VD rates between conventional laparoscopy (CL) and robotic-assisted laparoscopic surgery (RALS).
Main Methods:
- Systematic review and meta-analysis of PRISMA-guided studies.
- Inclusion of prospective, retrospective, and randomized trials.
- Calculation of relative risks (RRs) and heterogeneity assessment (I² statistic).
Main Results:
- Eleven studies (728 patients) were included; 225 underwent CL, 503 RALS.
- Overall VD incidence was 7.1%, significantly lower after RALS (4.4%) vs. CL (13.3%).
- Persistent VD (>1 month) was also reduced with RALS (5.2%) compared to CL (10.2%).
Conclusions:
- RALS is associated with a lower risk of both immediate and persistent VD after colorectal DIE surgery.
- These findings support the preferential use of RALS for DIE surgery in patients at high risk for VD.
- RALS may offer improved functional outcomes for patients undergoing complex endometriosis surgery.
