Bladder endometriosis: laparoscopic treatment and follow-up

Roberta Granese, R. Granese, Granese R, M. Candiani, Massimo Candiani, A Perino, Renato Venezia, R Venezia, Venezia R, G Cucinella, Gaspare Cucinella
European journal of obstetrics, gynecology, and reproductive biology · 2008 · vol. 140(1) , pp. 114–117 · doi:10.1016/j.ejogrb.2008.03.011 · PMID:18462860 · W2129269751
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This paper describes the laparoscopic treatment and follow-up outcomes for patients with bladder endometriosis.

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Abstract

OBJECTIVES: This study aims to show the treatment outcome in women affected by isolated bladder endometriosis who underwent laparoscopic surgery in our units. Only women with deep nodules located in the bladder were selected, thus excluding women with deep lesions located in other sites. STUDY DESIGN: Between March 2005 and 2007, women with deep vesical endometriosis, referring to the Departments of Obstetrics and Gynaecology of University Hospitals "G. Martino"of Messina, "Paolo Giaccone"of Palermo and "San Paolo"of Milano, were respectively recruited. A preoperative assessment of the pathology was performed. Women who were concomitantly diagnosed deep nodules of the rectovaginal septum and/or endometriotic ovarian cysts were excluded. A medical therapy with oral contraceptive and/or GnRH analogues was first proposed to the patients affected. If medical treatment failed, a laparoscopic treatment was suggested. We performed a segmental resection of the involved wall or an extramucosal dissection of the bladder according to the cases. A clinical and an instrumental evaluation by ultrasound was performed every 6 months after surgery for the first year and subsequently every 12 months. At the time of referral, patients were also questioned about any recurrence of symptoms. RESULTS: Eight women, with a mean age of 33.8 (range 30-37 years; S.D.=2.5) and a mean parity of 1 (range 0-2) were recruited. Medical therapy failed in all cases and the women underwent laparoscopic treatment. Surgery was complete in all cases without a need for ureteral cannulation. No intraoperative complications occurred. The mean estimated blood loss was 98 ml (range 40-200 ml). All patients underwent at least the first follow-up assessment. In none of the women, recurrence of bladder endometriotic nodules was documented. In contrast, urinary symptoms were reported in three cases. Nevertheless, all the patients reported improvement of symptoms and declared to be satisfied. CONCLUSIONS: We recommend surgical eradication of bladder lesions. Laparoscopic treatment, in the hands of an expert surgeon, is the management of choice. It offers the best approach to the diagnosis allowing good long-term results, with a less invasive approach. Large multicentric studies are however required prior to drawing definite conclusions.

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Condition tags

endometriosisbladder_endometriosis

MeSH descriptors

Endometriosis Laparoscopy Laparoscopy Urinary Bladder Diseases Urologic Surgical Procedures Urologic Surgical Procedures Adult Adult Endometriosis Endometriosis Female Female Follow-Up Studies Follow-Up Studies Gynecologic Surgical Procedures Gynecologic Surgical Procedures Humans Humans Patient Satisfaction Patient Satisfaction

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

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