Conservative laparoscopic management of urinary tract endometriosis (UTE): surgical outcome and long-term follow-up.

Abstract:

OBJECTIVE:To evaluate surgical outcome and long-term follow-up of conservative laparoscopic management of urinary tract endometriosis (UTE). DESIGN:Prospective study. SETTING:Tertiary-care university hospital. PATIENT(S):Women with laparoscopic diagnosis and histologic confirmation of urinary bladder or ureteral endometriosis who agreed to undergo long-term follow-up after laparoscopic management. INTERVENTION(S):(1) Laparoscopic partial cystectomy for bladder endometriosis. (2) Uretric endometriosis laparoscopically managed by: uretrolysis only; segmental ureterectomy and terminoterminal anastomosis; or segmental ureterectomy and uretrocystoneostomy. MAIN OUTCOME MEASURE(S):Variables assessed were: preoperative findings, operative details (type and site of UTE, type of intervention, perioperative complications), and long-term follow-up (persistence/recurrence of preoperative urinary symptoms, if present, and anatomic relapse of the disease). RESULT(S):Mean operating time was 152.8+/-41.7 minutes. Mean drop in hemoglobin was 1.9+/-1.6 g/dL. Average hospital stay was 6 days. After surgery, 11 women had fever>38 degrees C and four presented transient urinary retention. During a follow-up period of 36 months, endometriosis recurred in eight patients with no evidence of bladder or ureteral reinvolvement, and there was a significant reduction in the mean score of dysuria and suprapubic pain maintained during the whole follow-up period. CONCLUSION(S):Results of long-term follow-up demonstrate significant reduction in preoperative symptoms with no anatomic relapse.

journal_name

Fertil Steril

journal_title

Fertility and sterility

authors

Seracchioli R,Mabrouk M,Montanari G,Manuzzi L,Concetti S,Venturoli S

doi

10.1016/j.fertnstert.2009.04.019

subject

Has Abstract

pub_date

2010-08-01 00:00:00

pages

856-61

issue

3

eissn

0015-0282

issn

1556-5653

pii

S0015-0282(09)00863-2

journal_volume

94

pub_type

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