Deep endometriosis inflicting the bladder: long-term outcomes of surgical management.

Abstract:

OBJECTIVE:To assess the efficacy and safety of laparoscopic treatment of bladder endometriosis, especially in cases of full thickness endometriotic nodules. DESIGN:Retrospective review of medical records. SETTING:Tertiary medical center and a referral center for endometriosis. POPULATION:Sixty-nine patients with bladder endometriosis that underwent surgery between January 2005 and December 2011. METHODS:The records of all patients with bladder endometriosis were reviewed and the pre-, intra- and postoperative information of patients who underwent surgery was collected. MAIN OUTCOME MEASURES:Efficacy, safety and long-term outcome of laparoscopic treatment of bladder endometriosis. RESULTS:The mean age of 69 patients with bladder endometriosis was 31.3 ± 4.6 years. Preoperative urinary symptoms (such as frequency, urgency, dysuria and others) were present in 28 (40.0%) patients. Laparoscopy was performed in all patients. Deep detrusor involvement was found in 45 (65.2%) patients. Of these, 21 patients underwent partial cystectomy due to a full thickness lesion. Deep nodule resection without bladder invasion was performed in 24 (34.8%) patients and bladder nodule coagulation and ablation in the remaining 24 (34.8%) patients with superficial involvement. No intraoperative complications were noted. Postoperative follow-up results were available for all patients. After a median (range) follow-up period of 60 (4-92) months, 92.7% of the patients were asymptomatic or reported improvement in symptoms. CONCLUSIONS:After a long-term follow-up surgical management of bladder endometriosis is strongly recommended. During surgery, careful inspection and full excision of bladder lesions should be performed. Laparoscopic excision is a safe and efficacies approach.

journal_name

Arch Gynecol Obstet

authors

Schonman R,Dotan Z,Weintraub AY,Bibi G,Eisenberg VH,Seidman DS,Goldenberg M,Soriano D

doi

10.1007/s00404-013-2917-6

subject

Has Abstract

pub_date

2013-12-01 00:00:00

pages

1323-8

issue

6

eissn

0932-0067

issn

1432-0711

journal_volume

288

pub_type

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