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Archives of Gynecology and Obstetrics

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01-07-2011 | General Gynecology

Laparoscopic nerve-sparing surgery of deep infiltrating endometriosis: description of the technique and patients’ outcome

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

Published in: Archives of Gynecology and Obstetrics | Issue 1/2011

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.

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Title: Laparoscopic nerve-sparing surgery of deep infiltrating endometriosis: description of the technique and patients’ outcome
Authors: A. Kavallaris
C. Banz
N. Chalvatzas
A. Hornemann
D. Luedders
K. Diedrich
M. Bohlmann
Publication date: 01-07-2011
Publisher: Springer-Verlag
Published in: Archives of Gynecology and Obstetrics / Issue 1/2011
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-010-1624-9

At a glance: The STEP trials

Springer Medicine

Laparoscopic nerve-sparing surgery of deep infiltrating endometriosis: description of the technique and patients’ outcome

Abstract

Introduction

Patients and methods

Results

Discussion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Patients and methods

Results

Discussion

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