Authors: E Volpi A Ferrero P Sismondi
Publish Date: 2004/05/27
Volume: 18, Issue: 7, Pages: 1109-1112
Abstract
A total of 24 patients operated for deep endometriosis were considered During surgery and on videotapes of the procedures we evaluated single or doublesided resection of the uterosacral ligaments and other structure’s visualization of the inferior hypogastric and the splanchnic nerves The most important objective criteria for resection of the nerves was urinary retention after surgery which was compared to surgical resection on the videotapesVisualization of the inferior hypogastric nerves was possible in 20 of 22 patients 901 Eight of the 24 patients had at least one inferior hypogastric nerve resected 333 In seven patients 292 resection of the uterosacral ligaments was bilateral and in three of these the nerves were resected Postoperatively the median residual urine volume after the first spontaneous voiding was 40 ml range 20–400 Seven of eight patients 292 with resection of the nerves had urinary retention and selfcatheterization at discharge The difference in urinary residuum after first voiding between patients undergoing selfcatheterization and patients released without the catheter was significant p 001 The median time to resume the voiding function in patients with selfcatheterization was 18 days range 9–45Nerve visualization is possible by means of laparoscopic surgery for deep endometriosis in a high rate of patients Careful technique is necessary but the laparoscopic approach may help Even singlesided radical dissection can induce important urinary retention
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