Outcomes of Surgical Management of Deep Infiltrating Endometriosis of the Ureter and Urinary Bladder

Francisc Rozsnyai, Horace Roman, Benoit Resch, B. Resch, F. Dugardin, Fabrice Dugardin, Juan Berrocal, J. Ortiz Berrocal, Gérôme Descargues, G Descargues, Remi Schmied, Malik Boukerrou, Loïc Marpeau, Loı̈c Marpeau, CIRENDO Study Group
JSLS : Journal of the Society of Laparoendoscopic Surgeons · 2011 · vol. 15(4) , pp. 439–447 · doi:10.4293/108680811x13176785203798 · PMID:22643496 · PMC3340950 · W2324482749
article OA: gold CC0 ⤵ 35 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study analyzed surgical outcomes for 30 women with deep infiltrating endometriosis of the ureter or bladder, finding that conservative surgery with postoperative amenorrhea is often successful despite potential complications.

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Abstract

OBJECTIVES: To report the outcomes of surgical management of urinary tract endometriosis and discuss the choice between conservative and radical surgery. MATERIALS AND METHODS: We reviewed data concerning women managed for ureteral or bladder deep infiltrating endometriosis in 5 surgical departments participating in the CIRENDO prospective database. Preoperative data, surgical procedure data, and postoperative outcomes were analyzed. RESULTS: Data from 30 women pooled in the database showed 15 women presenting with ureteral endometriosis, 14 women with bladder nodules, and 1 with both types of lesions. Ureterolysis was performed in 14 cases; the ureter was satisfactorily freed in 10 of these. In 4 women over 40 years old, who were undergoing definitive amenorrhea, moderate postoperative ureteral stenosis was tolerated and later improved in 3 cases, while the fourth underwent secondary ureteral resection and ureterocystoneostomy. Primary ureterectomy was carried out in 4 women. Two cases of intrinsic ureteral endometriosis were found in 5 ureter specimens. Four complications were related to surgical procedures on ureteral nodules, and 2 complications followed the removal of bladder endometriosis. Delayed postoperative outcomes were favorable with a significant improvement in painful symptoms and an absence of unpleasant urinary complaints, except for one patient with prolonged bladder denervation. CONCLUSION: Conservative surgery, in association with postoperative amenorrhea, can be proposed in a majority of cases of urinary tract endometriosis. Although the outcomes are generally favorable, the risk of postoperative complications should not be overlooked, as surgery tends to be performed in conjunction with other complex procedures such as colorectal surgery.

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Condition tags

endometriosisdie_deep_infiltratingbladder_endometriosis

MeSH descriptors

Endometriosis Laparoscopy Ureteral Diseases Urinary Bladder Diseases Adult Diagnostic Imaging Endometriosis Endometriosis Female France France Humans Laparoscopy Postoperative Complications Postoperative Complications Retrospective Studies Treatment Outcome Ureteral Diseases Ureteral Diseases Urinary Bladder Diseases

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