ADDITIONAL PROCEDURES FOR PELVIC SURGEONS

In: Nezhats Operative Gynecologic Laparoscopy and Hysteroscopy · 2011 · pp. 537–551 · doi:10.1017/cbo9780511547362.023 · W152880581
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This chapter from a surgical textbook discusses the utility of cystoscopy for pelvic surgeons to diagnose lower urinary tract disorders and manage complications. The authors note that incidental findings during the procedure can reveal bladder endometriosis, with one case involving complete ureteral obstruction leading to renal necrosis in a patient with invasive disease. Although gynecologists often lack formal training in this technique, the text highlights its relevance given the high prevalence of bladder-related pain and interstitial cystitis among patients with chronic pelvic conditions. Relevance to endometriosis: listed as one indication for GnRH antagonists, though the paper's main focus is uterine fibroids.

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Abstract

Cystoscopy, the gold standard for diagnosis of disorders and injuries of the lower urinary tract, provides another tool for prevention and active management of urologic pathology and surgical complications by allowing the surgeon to assess the integrity and function of the urethra, bladder, and ureters. At our center, we have incidentally detected bladder endometriosis, polyps, malignant lesions, diverticula, duplicated ureter, and interstitial cystitis. One case of complete ureteral obstruction and renal necrosis due to invasive endometriosis was detected during an incidental cystoscopy. Contralateral periureteral disease was treated, resulting in successful conservation of the other kidney.
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- Frontmatter - Contents - Contributing Authors - Forewords - Preface - 1 HISTORY OF MODERN OPERATIVE LAPAROSCOPY - 2 EQUIPMENT - 3 ANESTHESIA - 4 LAPAROSCOPIC ACCESS - 5 LAPAROSCOPIC SUTURING - 6 INTRAPERITONEAL AND RETROPERITONEAL ANATOMY - 7 FERTILITY - 8 HYSTEROSCOPY - 9 MANAGEMENT OF ADNEXAL MASSES - 10 ENDOMETRIOSIS - 11 LAPAROSCOPIC ADHESIOLYSIS AND ADHESION PREVENTION - 12 LEIOMYOMAS - 13 HYSTERECTOMY - 14 PELVIC FLOOR - 15 LAPAROSCOPIC TREATMENT OF CHRONIC PELVIC PAIN - 16 GYNECOLOGIC MALIGNANCY - 17 LAPAROSCOPY IN THE PREGNANT PATIENT - 18 MINIMAL ACCESS PEDIATRIC SURGERY - 19 LAPAROSCOPIC VASCULAR SURGERY IN 2007 - 20 COMPLICATIONS IN LAPAROSCOPY - 21 ADDITIONAL PROCEDURES FOR PELVIC SURGEONS - 22 LAPAROSCOPY SIMULATORS FOR TRAINING BASIC SURGICAL SKILLS, TASKS, AND PROCEDURES - 23 ROBOT-ASSISTED LAPAROSCOPY - 24 HYSTEROSCOPY AND ENDOMETRIAL CANCER - 25 OVERVIEW OF COMPLICATIONS - Appendix - Atlas - Index Published online by Cambridge University Press: 23 December 2009 Book contents - Frontmatter - Contents - Contributing Authors - Forewords - Preface - 1 HISTORY OF MODERN OPERATIVE LAPAROSCOPY - 2 EQUIPMENT - 3 ANESTHESIA - 4 LAPAROSCOPIC ACCESS - 5 LAPAROSCOPIC SUTURING - 6 INTRAPERITONEAL AND RETROPERITONEAL ANATOMY - 7 FERTILITY - 8 HYSTEROSCOPY - 9 MANAGEMENT OF ADNEXAL MASSES - 10 ENDOMETRIOSIS - 11 LAPAROSCOPIC ADHESIOLYSIS AND ADHESION PREVENTION - 12 LEIOMYOMAS - 13 HYSTERECTOMY - 14 PELVIC FLOOR - 15 LAPAROSCOPIC TREATMENT OF CHRONIC PELVIC PAIN - 16 GYNECOLOGIC MALIGNANCY - 17 LAPAROSCOPY IN THE PREGNANT PATIENT - 18 MINIMAL ACCESS PEDIATRIC SURGERY - 19 LAPAROSCOPIC VASCULAR SURGERY IN 2007 - 20 COMPLICATIONS IN LAPAROSCOPY - 21 ADDITIONAL PROCEDURES FOR PELVIC SURGEONS - 22 LAPAROSCOPY SIMULATORS FOR TRAINING BASIC SURGICAL SKILLS, TASKS, AND PROCEDURES - 23 ROBOT-ASSISTED LAPAROSCOPY - 24 HYSTEROSCOPY AND ENDOMETRIAL CANCER - 25 OVERVIEW OF COMPLICATIONS - Appendix - Atlas - Index Cystoscopy, the gold standard for diagnosis of disorders and injuries of the lower urinary tract, provides another tool for prevention and active management of urologic pathology and surgical complications by allowing the surgeon to assess the integrity and function of the urethra, bladder, and ureters. At our center, we have incidentally detected bladder endometriosis, polyps, malignant lesions, diverticula, duplicated ureter, and interstitial cystitis. One case of complete ureteral obstruction and renal necrosis due to invasive endometriosis was detected during an incidental cystoscopy. Contralateral periureteral disease was treated, resulting in successful conservation of the other kidney. Cystoscopic technique, unfortunately, is not routinely taught during obstetrics/gynecology residency training; therefore, many gynecologists do not feel comfortable performing the procedure. This is unfortunate as gynecologists deal with urogynecologic issues daily with conditions such as urinary incontinence, pelvic organ prolapse, and severe endometriosis involving the lower urinary tract. Two large multicenter studies demonstrated that 66% to 80% of patients with chronic pelvic pain had evidence of bladder-origin pain due to bladder epithelial damage or interstitial cystitis. In the gynecologic literature, chronic pelvic pain is associated with endometriosis in 30% to 87% of cases as well. The surgical treatment of pelvic pain is the most frequent indication for operative laparoscopy, although in as many as 40% of patients, no pathology is found. - Type - Chapter - Information - Nezhat's Operative Gynecologic Laparoscopy and Hysteroscopy , pp. 537 - 551Publisher: Cambridge University PressPrint publication year: 2008 Accessibility compliance for the PDF of this chapter is currently unknown and may be updated in the future. - 1 - Cited by To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle. Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply. Find out more about the Kindle Personal Document Service. - ADDITIONAL PROCEDURES FOR PELVIC SURGEONS - - Book: Nezhat's Operative Gynecologic Laparoscopy and Hysteroscopy - Online publication: 23 December 2009 To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox. - ADDITIONAL PROCEDURES FOR PELVIC SURGEONS - - Book: Nezhat's Operative Gynecologic Laparoscopy and Hysteroscopy - Online publication: 23 December 2009 To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive. - ADDITIONAL PROCEDURES FOR PELVIC SURGEONS - - Book: Nezhat's Operative Gynecologic Laparoscopy and Hysteroscopy - Online publication: 23 December 2009

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endometriosisbladder_endometriosisinterstitial_cystitis

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