Impact of deep resection of endometriosis in the pelvis on urodynamic parameters.

Acta cirurgica brasileira Pub Date : 2023-12-01 eCollection Date: 2023-01-01 DOI:10.1590/acb386323
Jardel Cavalcante de Farias, Maria do Desterro Soares Brandão Nascimento, Plínio da Cunha Leal, Caio Márcio Barros de Oliveira, Ed Carlos Rey Moura
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Abstract

Purpose: To evaluate the effects of deep resection of endometriosis in the posterior pelvic region on urodynamic parameters.

Methods: A prospective observational study conducted with female patients diagnosed with deep pelvic endometriosis before and after endometriosis resection surgery. Clinical history, image exams, the Female Lower Urinary Tract Symptoms questionnaire, urodynamic examination, cystometry, and voiding study were evaluated.

Results: Patients aged 30-39 years old, operative duration of 132.5 minutes, and 2.7 days of hospital stay. Uroflowmetry and cystometry showed tendency for an increase after the surgery in the flow duration, time to maximum flow, and first voiding desire and decreased residual volume and maximum cystometric capacity. Opening, maximum urinary flow, and maximum flow pressure decreased at T1, and the closing parameters increased, although statistically non significant. The variables decreased at T1 in the urodynamic, except for detrusor overactivity. Although we observed a reasonable number of low bladder compliance and abnormal bladder sensation, the results were maintained at T1. General scores for filling and incontinence showed a significant decrease after surgery.

Conclusions: A significant response in the patient's perception of urinary function was demonstrated after surgery. It is observed that the surgical procedure did not affect the uroflowmetric and cystometric characteristics of the evaluated patients.

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骨盆子宫内膜异位症深度切除对尿动力学参数的影响。
目的:探讨盆腔后区子宫内膜异位症深度切除术对尿动力学参数的影响。方法:对子宫内膜异位症切除术前后诊断为盆腔深部子宫内膜异位症的女性患者进行前瞻性观察研究。临床病史、影像学检查、女性下尿路症状问卷、尿动力学检查、膀胱测量和排尿研究进行评估。结果:患者年龄30 ~ 39岁,手术时间132.5分钟,住院时间2.7 d。尿流术和膀胱术显示术后血流持续时间、最大流量时间、第一次排尿愿望和减少的残余体积和最大膀胱容量均有增加的趋势。在T1时,开度、最大尿流量和最大尿流量压力下降,关闭参数增加,但无统计学意义。除逼尿肌过度活动外,尿动力学指标在T1时均有所下降。虽然我们观察到合理数量的膀胱顺应性低和膀胱感觉异常,但结果维持在T1。术后填充物和尿失禁的综合评分明显下降。结论:术后患者对泌尿功能的感知有明显的改善。我们观察到,手术过程不影响评估患者的尿流量和膀胱测量特征。
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