Surgical Management of Urinary Tract Endometriosis: A 1-year Longitudinal Multicenter Pilot Study at 31 French Hospitals (by the FRIENDS Group)
Charles-André Philip,
Charles‐André Philip,
Froc E,
Elise Froc,
Chapron C,
Charles Chapron,
Thomas Hebert,
Hebert T,
Douvier S,
Serge Douvier,
Laurence Filipuzzi,
Filipuzzi L,
Philippe Descamps,
Descamps P,
Agostini A,
Aubert Agostini,
Collinet P,
Pierre Collinet,
Peter von Theobald,
von Theobald P,
Roman H,
Horace Roman,
Dubernard G,
Gil Dubernard
other
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by gemini-2.5-flash-lite, 2026-06-08
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This pilot study analyzed 232 patients with urinary tract endometriosis, finding that laparoscopic surgery is generally safe, but ureteral resection is associated with more complications, particularly when performed via laparotomy.
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Abstract
STUDY OBJECTIVE: To describe the surgical management and risks of postoperative complications of patients with urinary tract endometriosis in France in 2017.
DESIGN: Multicenter retrospective cohort pilot study.
SETTING: Departments of gynecology at 31 expert endometriosis centers.
PATIENTS: All women managed surgically for urinary tract endometriosis from January 1, 2017, to December 31, 2017. We distinguished patients with isolated bladder endometriosis or isolated ureteral endometriosis (IUE) from those with endometriosis in both locations (mixed locations [ML]).
INTERVENTIONS: Surgeons belonging to the French Colorectal Infiltrating Endometriosis Study (FRIENDS) group enrolled patients who filled a 24-item questionnaire on the day of the inclusion and 3 months later. Data were collected on operative routes, surgical management, and postoperative complications according to the Clavien-Dindo classification in a single anonymized database.
MEASUREMENTS AND MAIN RESULTS: A total of 232 patients from 31 centers were included. Isolated bladder endometriosis was found in 82 patients (35.3%), IUE in 126 patients (54.4%), and ML in 24 patients (10.3%). Surgery was performed by laparoscopy, laparotomy, or robot-assisted laparoscopy in 74.1%, 11.2%, and 14.7% of the cases, respectively. Among the 150 ureteral lesions (IUE and ML), 114 were managed with ureterolysis (76%), 28 with ureteral resection (18.7%), 4 with nephrectomy (2.7%), and 23 with cystectomy (15.3%). Concerning bladder endometriosis, a partial cystectomy was performed in 94.3% of the cases. We reported 61 postoperative complications (26.3%): 44 low-grade complications according to the Clavien-Dindo classification (18%), 16 grade III complications (7%), and 1 grade IV complication (peritonitis).
CONCLUSION: The surgical management of ureteral and bladder endometriosis is usually feasible and safe through laparoscopic surgery. Ureteral resection, when necessary, is more strongly associated with laparotomy and with more complications than other procedures. Prospective controlled studies are still mandatory to assess the best surgical management for patients.
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Condition tags
endometriosisbladder_endometriosis
MeSH descriptors
Endometriosis
Endometriosis
Laparoscopy
Laparoscopy
Ureter
Ureteral Diseases
Ureteral Diseases
Female
Hospitals
Humans
Pilot Projects
Prospective Studies
Retrospective Studies
Treatment Outcome
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- europepmc
- last seen: 2026-09-16T06:11:32.772430+00:00
- pubmed
- last seen: 2026-05-13T22:24:37.768885+00:00
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