TY - JOUR
T1 - Deep endometriosis inflicting the bladder
T2 - Long-term outcomes of surgical management
AU - Schonman, Ron
AU - Dotan, Zohar
AU - Weintraub, Adi Y.
AU - Bibi, Guy
AU - Eisenberg, Vered H.
AU - Seidman, Daniel S.
AU - Goldenberg, Mordechai
AU - Soriano, David
PY - 2013/12
Y1 - 2013/12
N2 - 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.
AB - 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.
KW - Bladder endometriosis
KW - Deep nodule resection
KW - Laparoscopy
KW - Long-term follow-up
KW - Partial cystectomy
UR - http://www.scopus.com/inward/record.url?scp=84889097495&partnerID=8YFLogxK
U2 - 10.1007/s00404-013-2917-6
DO - 10.1007/s00404-013-2917-6
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C2 - 23778640
AN - SCOPUS:84889097495
SN - 0932-0067
VL - 288
SP - 1323
EP - 1328
JO - Archives of Gynecology and Obstetrics
JF - Archives of Gynecology and Obstetrics
IS - 6
ER -