Urological aspects of advanced endometriosis

In: Urology reports (St. - Petersburg) · 2025 · vol. 15(1) , pp. 109–115 · doi:10.17816/uroved639990 · W4410155595
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This review examines the clinical course, diagnostic challenges, and multidisciplinary treatment approaches for advanced endometriosis involving the urinary system.

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This review examines the urological complications associated with advanced endometriosis, focusing on deep infiltrative lesions that involve adjacent organs and systems. The authors analyze domestic and international literature alongside clinical cases from patients aged 19 to 37 to highlight diagnostic challenges and the variability of symptoms in young women. They emphasize that disease onset often precedes symptom appearance and first childbirth, necessitating a specialized multidisciplinary approach involving gynecologists, urologists, and surgeons for effective diagnosis and treatment. This paper is centrally about endometriosis — specifically the management of deep infiltrating endometriosis with urinary tract involvement.

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Abstract

Endometriosis, or endometrioid disease, ranks third in the structure of gynecological morbidity and is considered a significant medical and social problem. In advanced endometriosis, adjacent organs and systems become involved, leading to functional impairments and, in some cases, complete loss of function and disability in young women. The article highlights the clinical course, variability of symptoms, and diagnostic challenges in patients with deep infiltrative endometriosis. A review of both domestic and international literature was conducted using such search engines as eLibrary.ru, Scopus, and PubMed. The article also presents clinical cases of deep infiltrative endometriosis. With the voluntary informed consent of the patients, an analysis of medical records, clinical history, laboratory and instrumental examination results, and surgical treatment protocols was conducted. Endometriosis is a disease of women of reproductive age. In our observations, the youngest patient was 19 years old, and the oldest was 37 years old. This is consistent with the data from domestic and international sources, indicating that patients suffering from external genital or extragenital endometriosis are usually young women, with the onset of the disease long before the appearance of symptoms. The average age of becoming a mother for the first time in various regions of the Russian Federation in 2019 was 25.9 years. If this trend continues, women will develop endometriosis before having their first child. Patients with deep infiltrative endometriosis require a specialized, multidisciplinary approach to diagnosis and treatment of their condition involving a gynecologist, urologist, and surgeon.
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Urological aspects of advanced endometriosis - Authors: Murzin M.O.1, Frank M.A.1, Oboskalova T.A.1, Kudryashov N.V.1 - Affiliations: - Ural State Medical University - Issue: Vol 15, No 1 (2025) - Pages: 109-115 - Section: Сlinical observations - Submitted: 28.10.2024 - Accepted: 15.01.2025 - Published: 07.05.2025 - URL: https://journals.eco-vector.com/uroved/article/view/639990 - DOI: https://doi.org/10.17816/uroved639990 - ID: 639990 Cite item Abstract Endometriosis, or endometrioid disease, ranks third in the structure of gynecological morbidity and is considered a significant medical and social problem. In advanced endometriosis, adjacent organs and systems become involved, leading to functional impairments and, in some cases, complete loss of function and disability in young women. The article highlights the clinical course, variability of symptoms, and diagnostic challenges in patients with deep infiltrative endometriosis. A review of both domestic and international literature was conducted using such search engines as eLibrary.ru, Scopus, and PubMed. The article also presents clinical cases of deep infiltrative endometriosis. With the voluntary informed consent of the patients, an analysis of medical records, clinical history, laboratory and instrumental examination results, and surgical treatment protocols was conducted. Endometriosis is a disease of women of reproductive age. In our observations, the youngest patient was 19 years old, and the oldest was 37 years old. This is consistent with the data from domestic and international sources, indicating that patients suffering from external genital or extragenital endometriosis are usually young women, with the onset of the disease long before the appearance of symptoms. The average age of becoming a mother for the first time in various regions of the Russian Federation in 2019 was 25.9 years. If this trend continues, women will develop endometriosis before having their first child. Patients with deep infiltrative endometriosis require a specialized, multidisciplinary approach to diagnosis and treatment of their condition involving a gynecologist, urologist, and surgeon. Full Text About the authors Mikhail O. Murzin Ural State Medical University Author for correspondence. Email: [email protected] ORCID iD: 0009-0002-1976-5591 MD, Cand. Sci. (Medicine) Russian Federation, EkaterinburgMikhail A. Frank Ural State Medical University Email: [email protected] ORCID iD: 0000-0002-6455-0410 SPIN-code: 2667-2393 MD, Dr. Sci. (Medicine) Russian Federation, EkaterinburgTatiana A. Oboskalova Ural State Medical University Email: [email protected] ORCID iD: 0000-0003-0711-7896 SPIN-code: 9364-2321 MD, Dr. Sci. (Medicine), Professor Russian Federation, EkaterinburgNikita V. Kudryashov Ural State Medical University Email: [email protected] MD Russian Federation, EkaterinburgReferences - Suhih GT, Serov VN, Adamyan LV, et al. Algorithms for the management of patients withendometriosis: the agreed position of experts of the Russian Society of Obstetricians and Gynecologists. Obstetrics and Gynecology. 2023;(5):159–176. doi: 10.18565/aig.2023.132 EDN: DTJOZV - Bekker KM, Bokor A, Hajkinhajmo O, et al. Guidelines of the European Society of Human Reproduction and Embryology (ESHRE): endometriosis. Obstetrics and Gynecology: News, Opinions, Training.2023; 11(1): 67–93. doi: 10.33029/2303-9698-2023-11-1-67-93 EDN: AGEBEE - Matronickij RB, Stoletova TA, Veselov VV, et al. Atlas on endoscopic diagnosis of colorectal endometriosis. Moscow: MEDpress-inform; 2023. 68 p. (In Russ.) - Ailamazyan EK, Yarmolinskaya MI, Molotkov AS, Tsitskarava DZ. Classification of endometriosis. Journal of Obstetrics and Women’s Diseases. 2017;66(2):77–92. doi: 10.17816/jowd66277-92 EDN: YNBWDV - Muftaidinova SK, Faizullin LZ, Chuprynin VD, et al. Clinical and diagnostic aspects of deep infiltrative endometriosis (diagnosis, treatment, recurrence). Gynecology. 2021;23(4):307–313. doi: 10.26442/20795696.2021.4.201040 EDN: VZJKEY - Hachatryan AM, Mel’nikov MV, Chuprynin VD, et al. Clinic and diagnosis of endometriosis of the urinary tract. Obstetrics and Gynecology. 2013;(12):52–57. EDN: RTECNJ - Hachatryan AM, Kogan EA, Chuprynin VD, et al. Infiltrative endometriosis of the urinary tract: mechanisms of growth and progression. Clinical, morphological and immunohistochemical study. Obstetrics and Gynecology. 2016;(6):78–86. doi: 10.18565/aig.2016.6.78-86 EDN: WGAYKR - Hachatryan AM, Chuprynin VD, Hil’kevich EG, et al. Surgical treatment of infiltrative endometriosis of the urinary tract. Obstetrics and Gynecology. 2016;(4):72–78. doi: 10.18565/aig.2016.4.72-78 EDN: VWWWMF - Melnikov MV, Chuprynin VD, Askolskaya SI, et al. Diagnostics and tactics of surgical treatment of infiltrative endometriosis in patients of reproductive age. Obstetrics and Gynecology. 2012;(7):42–49. EDN: PIIDPP - Unanian AL, Sidorova IS, Kogan EA. External endometriosis: Problems of postoperative therapy. Russian Bulletin of Obstetrician-Gynecologist. 2013;13(3):56–59. EDN: QYPSAL - Ishchenko AI, Bryunin DV, Shpot’ EV, et al. Infiltrative endometriosis with damage to the ureter — clinical experience of interaction between a gynecologist and a urologist in diagnosis, surgical treatment and monitoring of the patient. Urologiia. 2022;(4):86–90. doi: 10.18565/urology.2022.4.86-90 EDN: MHOPCN - Arkhangel’skiy VN, Kalachikova ON. Maternal age at first birth: dynamics, regional differences, determination. Economic and Social Changes: Facts, Trends, Forecast. 2020;13(5):200–217. doi: 10.15838/esc.2020.5.71.12 EDN: GGMDHG - Farina-Perez L. The Role of the medical illustrator in the development of Spanish urological endoscopy: Eighty years of Endoscopia urinaria by Antonio Puigvert and illustrated by Rafael Alemany. De Historia Urologiae Europaeae. 2019; 26:85–92.

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