Chronic urinary retention and pelvic floor hypertonicity after surgery for endometriosis: A case series

The purpose of this study was to evaluate 4 cases of chronic urinary retention and pelvic floor muscle spasms after surgery for endometriosis. These patients underwent a complete history, physical exam, and diagnostic work- up. The results were analyzed with regards to type and extent of inciting surgery, diagnostic findings, postoperative recovery, and treatment success. The patients' mean age was 39.5 years and all had undergone various surgical interventions for endometriosis. In addition to urinary retention, all developed debilitating pelvic floor muscle spasm postoperatively. Physical exam revealed pelvic floor hypertonicity and urodynamics indicated hypoactive detrusor contractility. Neurodiagnostic testing gave evidence of neuropathy in all subjects. Extensive endometriosis surgery may pose a risk for postoperative bladder dysfunction and pelvic floor muscle spasm.