Laparoscopic nerve-sparing surgery of deep infiltrating endometriosis: Description of the technique and patients' outcome

A. Kavallaris*, C. Banz, N. Chalvatzas, A. Hornemann, D. Luedders, K. Diedrich, M. Bohlmann

*Korrespondierende/r Autor/-in für diese Arbeit
23 Zitate (Scopus)

Abstract

Introduction: The radical surgery of the deep infiltrating endometriosis of the rectovaginal septum and the uterosacral ligaments with or without bowel resection can cause a serious damage of the pelvic autonomic nerves with urinary retention and the need of self-catheterization. Patients and methods: We introduce a case series report of 16 patients with laparoscopic nerve-sparing surgery of deep infiltrating endometriosis. We describe the technique step by step and compare the patients' outcome with patients who had undergone a non-nerve-sparing surgical technique. In 12 patients, a double-sided and in four patients, a single-sided identification of the inferior hypogastric nerve and plexus were performed. Results: In all patients at least single-sided resection of the uterosacral ligaments were performed. Postoperatively dysmenorrhoea, pelvic pain, and dyspareunia disappeared in all patients. The average operating time was 82 min (range 45-185). Postoperatively, the overall time to resume voiding function was 2 days. The residual urine volume was in all patients <50 ml at two ultrasound measurements. Discussion: Identification of the inferior hypogastric nerve and plexus was feasible. In comparison with non-nerve-sparing surgical technique, no cases of bladder self-catheterization for a long or even life time was observed, confirming the importance of the nerve-sparing surgical procedure.

OriginalspracheEnglisch
ZeitschriftArchives of Gynecology and Obstetrics
Jahrgang284
Ausgabenummer1
Seiten (von - bis)131-135
Seitenumfang5
ISSN0932-0067
DOIs
PublikationsstatusVeröffentlicht - 01.07.2011

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