Partial colpectomy is a risk factor for urologic complications of colorectal resection for endometriosis

Abstract

Study objective: To evaluate urologic complications after colorectal resection for endometriosis.

Design: Cohort study (Canadian Task Force classification II-2).

Setting: Tertiary referral university hospital and expert center in endometriosis.

Patients: One hundred sixty-six women with colorectal endometriosis proven by transvaginal sonography and magnetic resonance imaging.

Intervention: Open or laparoscopic colorectal resection for endometriosis.

Measurements and main results: Forty-four patients (26.5%) experienced at least 1 urologic complication, including infection. Eight patients (4.8%) experienced postoperative symptomatic hydronephrosis requiring ureteral stent in 3 cases, a percutaneous nephrostomy in 1 case, and expectant management for the last 4. Urologic fistulas occurred in 5 patients (3%). Postoperative voiding dysfunction requiring self-catheterization was observed in 48 patients (28.9%). With univariate analysis, a relationship was found between voiding dysfunction and partial colpectomy (p = .001) and American Society of Reproductive Medicine total score (p = .02), and between the occurrence of urinary fistula and the use of prophylactic ureteral catheterization (p = .015) and parametrectomy (p = .02). A relationship was found between postoperative symptomatic hydronephrosis and the use of prophylactic ureteral catheterization (p = .003).

Conclusion: Colorectal resection for endometriosis can lead to urologic complications, particularly for patients requiring partial colpectomy, of which patients need to be informed.