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Master Thesis

Intérêt de la neuromodulation sacrée dans les troubles du bas appareil urinaire après chirurgie d'endométriose

Abstract : The most frequent complication of pelvic surgery of endometriosis is voiding dysfunction (VD). Sacral neuromodulation (SNM) had shown its effectiveness in the treatment of overactive bladder (OAB) and non-obstructive retention (NOR). The objective of this study was to evaluate the effectiveness of SNM in patients who suffered of LUTD after endometriosis surgery. Methods: A monocentric retrospective study was conducted from January 2011 to October 2019. All patients in whom a SNM testing was performed after one or more endometriosis surgeries, were included. Clinical data were collected from medical records. All SNM tests were performed according to International Continence Society best practice statement. An improvement of more than 50% of the symptoms allowed the implantation of the pulse generator (Interstim 2™, Medtronic, USA). Results: During the period, 16 patients were enrolled. Eleven patients had undergone deep infiltrating endometriosis (DIE) surgery. The median interval time between last endometriosis surgery and SNM test was 21.5 months [15.8 – 45.8]. Eight patients performed clean intermittent self-catheterization (CISC). Ten patients had a significant post-void residual (PVR), with a mean PVR volume at 218.6 (± 123.3) ml. Fourteen patients were implanted. After a median follow-up of 23 (1 – 43) months, 10 patients were always treated by SNM. Moreover, 3 patients were weaned from CISC. DIE surgery was not a predictive factor of failure of SNM, either than perform CISC. Conclusion: To our knowledge, our study reports the results of the largest series of patients treated with SNM after endometriosis surgery. SNM is an effective treatment of LUTD and allows weaning of CISC in some cases. The success rate of this study offers an interesting perspective to these young patients with limited therapeutic options.
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Master Thesis
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Submitted on : Monday, November 2, 2020 - 1:48:03 PM
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  • HAL Id : dumas-02985685, version 1


Annabelle Aublé. Intérêt de la neuromodulation sacrée dans les troubles du bas appareil urinaire après chirurgie d'endométriose. Médecine humaine et pathologie. 2020. ⟨dumas-02985685⟩



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