Bladder symptoms and urodynamic observations of patients with endometriosis confirmed by laparoscopy

Abstract

Endometriosis infiltrating the bladder wall is associated with painful bladder symptoms. Dysfunctional voiding suggests an impairment of the inferior hypogastric plexus by posterior DIE. Clinical preoperative evaluation of bladder function should be systematic; urodynamic tests could be of interest in selected patients with DIE. Endometriosis may be a major cause of bladder pain syndrome.

Authors' reply

“…In agreement with recent findings our study highlights the fact that urinary tract symptoms are highly prevalent in patients with deep endometriosis regardless of previous surgery. The aetiology of pelvic organ dysfunction is complex and includes pathophysiology of the pelvic nerves and plexuses.…”

Bladder Endometriosis: A Systematic Review of Pathogenesis, Diagnosis, Treatment, Impact on Fertility, and Risk of Malignant Transformation

“…A woman of reproductive age complaining of pain symptoms (dysmenorrhea, dyspareunia, and nonmenstrual pelvic pain) is at risk of DIE [32][33][34]. Some studies reported that DIE is associated with lower urinary symptoms (LUTS); however, the prevalence of this association is unclear ranging between 2% and 77% [35][36][37]. According to the findings of a recent research, no difference was reported in the rate of urgency, urinary frequency, voiding symptoms and bladder pain between patient with posterior endometriosis plus BE compared with those with posterior endometriosis only [37].…”

“…Some studies reported that DIE is associated with lower urinary symptoms (LUTS); however, the prevalence of this association is unclear ranging between 2% and 77% [35][36][37]. According to the findings of a recent research, no difference was reported in the rate of urgency, urinary frequency, voiding symptoms and bladder pain between patient with posterior endometriosis plus BE compared with those with posterior endometriosis only [37]. Dysuria, frequency, bladder pain, and, less commonly, hematuria, urgency, and urinary incontinence are symptoms related to the presence of BE [3,4,18,38,39].…”

“…Several studies have shown coexistence (16-78%) of these two conditions [47], defined by Chung et al [48,49] as ''evil twin syndrome''. Panel et al [37] investigated the characteristics of LUTS and urodynamic findings for patients with posterior endometriosis versus those with a posterior location and BE. Interestingly, the study revealed that two urodynamic signs commonly reported by patients with BPS (increased bladder sensation and painful bladder filling) were more frequent among patients with BE than in those with a posterior location only.…”

Nerve Sparing and Surgery for Deep Infiltrating Endometriosis: Pessimism of the Intellect or Optimism of the Will

“…Moreover, preoperative abnormalities in urodynamic examination may exist in as many as 50 to 96% of patients with deep endometriosis by impairment of the IHP in posterior deep infiltrating endometriosis. 14,20 Thus, incomplete resection in those cases with an aim to preserve pelvic nerves and restore function postoperatively may not be the ideal strategy, since disease evolution itself may further impair function in previously preserved nerves.…”