Surgery for bladder endometriosis: long-term results and concomitant management of associated posterior deep lesions

Charles Chapron, Antoine Bourret, Nicolás Chopin, ChopinNicolas, Nicolas Chopin, Bertrand Dousset, B. Dousset, Mahaut Leconte, Delphine Amsellem-Ouazana, Delphine Amsellem‐Ouazana, Dominique de Ziegler, Bruno Borghese
Human Reproduction · 2010 · vol. 25(4) , pp. 884–889 · doi:10.1093/humrep/deq017 · PMID:20129993 · W2133776533
article OA: bronze CC0 ⤵ 146 in-corpus citations
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Partial cystectomy for bladder endometriosis yields no recurrences over a mean 51-month follow-up, with symptomatic improvement, and associated posterior DIE nodules only require surgery if they are symptomatic.

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Abstract

BACKGROUND: Deep infiltrating endometriosis (DIE) is presented as a disease with high recurrence risk. Bladder DIE is the most frequent location in cases of urinary endometriosis. Surgical removal has been recommended for bladder DIE but long-term outcomes remains unevaluated. The objectives of this study are to evaluate the rate of recurrence after partial cystectomy for patients presenting with bladder DIE and to outline the surgical modalities for handling associated posterior DIE nodules. METHODS: Seventy-five consecutive patients with histologically proved bladder DIE were enrolled at a single tertiary academic center between June 1992 and December 2007. A partial cystectomy was performed for each patient. Complete surgical exeresis of all associated symptomatic DIE lesions was carried out during the same surgical procedure. Bladder DIE patients were classified into three groups: patients with isolated bladder DIE (Group A); patients with associated symptomatic posterior DIE (Group B); patients with associated asymptomatic posterior DIE (Group C). Bladder DIE recurrence was defined as a clinical reappearance of the disease or radiological evidence that mandated a new surgical procedure. We assessed pelvic pain symptoms pre- and post-operatively using a 10-cm visual analogue scale. RESULTS: In a series of 627 patients with DIE, we observed 75 patients (12%) with bladder DIE. With a 50.9 +/- 44.6 months mean follow-up after partial cystectomy no patient presented evidence of bladder DIE recurrence. Post-operatively, we observed a significant improvement with respect to pain symptoms, with only two patients (2.7%) developing major complications during follow-up. Among patients with non-operated associated asymptomatic posterior DIE lesions (n = 15), a second surgical procedure indicated for pain symptoms was necessary in only one patient (6.7%). CONCLUSIONS: For patients presenting with bladder DIE, no patients required further surgery for bladder recurrence after radical surgery consisting in partial cystectomy. Exeresis of associated posterior DIE nodules is indicated only when they are symptomatic.

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Condition tags

mesh:D004715endometriosisdie_deep_infiltratingbladder_endometriosis

MeSH descriptors

Endometriosis Urinary Bladder Diseases Adult Cystectomy Cystectomy Cystectomy Endometriosis Endometriosis Endometriosis Female Humans Middle Aged Pain Pain Recurrence Time Factors Treatment Outcome Urinary Bladder Diseases Urinary Bladder Diseases Urinary Bladder Diseases

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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. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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