Endometriose des Uro-Genitaltraktes

In: Springer Reference Medizin · 2022 · pp. 1–15 · doi:10.1007/978-3-642-41168-7_79-2 · W4296501466
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Endometriosis involves uterine-like tissue outside the uterus, frequently affecting genitourinary organs, with bladder involvement most common and ureteral stenosis requiring monitoring for kidney preservation.

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The paper reviews endometriosis affecting the uro-genital tract, describing the disease as endometrial-like tissue outside the uterine cavity and emphasizing that mechanisms remain incompletely understood, so causal therapy is not possible. It outlines that urinary tract involvement is not isolated but occurs in the context of genital tract endometriosis, with bladder endometriosis being most common, while ureteral stenosis is highlighted as a typically asymptomatic special case. The authors note that for women with deeply infiltrating endometriosis, the upper urinary tract should be routinely monitored to prevent kidney loss, and that hydronephrosis requires urgent surgical treatment even without symptoms. This paper is centrally about endometriosis — specifically uro-genital tract involvement, including bladder endometriosis and ureteral complications like asymptomatic stenosis and hydronephrosis.

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Zusammenfassung Die Endometriose ist durch das Auftreten von endometriumartigem Gewebe außerhalb des Cavum uteri charakterisiert. Sie ist eine zwar gutartige, jedoch herausfordernde Erkrankung, die in ihren ausgeprägten Erscheinungen mehrere genitale und extragenitale Organe involviert, und daher nur interdisziplinär sinnvoll angegangen werden kann. Nachdem die Pathomechanismen bis heute nicht vollständig geklärt sind, ist eine kausale Therapie weiterhin nicht möglich. Je nach Lebensphase der Frau steht die Verbesserung der Fertilität und oder der Lebensqualität im Mittelpunkt. Die Behandlung erfolgt primär konservativ. Bei spezifischen Beschwerden ist häufig aber auch eine chirurgische Intervention erforderlich. Eine Beteiligung des Harntraktes tritt nicht als isolierte Erkrankung auf, sondern muss im Kontext mit einer Endometriose des Genitaltraktes gesehen werden. Am häufigsten ist hier die Blasenendometriose. Die durch eine Endometriose verursachte Stenose des Harnleiters nimmt eine Sonderstellung ein. Sie ist typischerweise asymptomatisch. Wegen des drohenden Nierenverlustes muss deshalb bei Patientinnen mit einer tief infiltrierenden Endometriose der obere Harntrakt routinemäßig überwacht werden. Eine Hydronephrose erfordert eine sofortige chirurgische Therapie – auch ohne Symptome. Similar content being viewed by others Literatur Adamson GD (2013) Endometriosis fertility index: is it better than the present staging systems? Curr Opin Obstet Gynecol 25(3):186–192 Agarwal SK, Chapron C, Giudice LC, Laufer MR, Leyland N, Missmer SA et al (2019) Clinical diagnosis of endometriosis: a call to action. Am J Obstet Gynecol 220(4):354.e1–354.e12 AlKudmani B, Gatt I, Buell D, Salman J, Zohni K, Librach C et al (2018) In vitro fertilization success rates after surgically treated endometriosis and effect of time interval between surgery and in vitro fertilization. J Minim Invasive Gynecol 25(1):99–104 American Society for Reproductive Medicine (1997) Revised American Society for Reproductive Medicine classification of endometriosis. Fertil Steril 67:817–821 Antonelli A, Simeone C, Zani D, Sacconi T, Minini G, Canossi E et al (2006) Clinical aspects and surgical treatment of urinary tract endometriosis: our experience with 31 cases. Eur Urol 49(6):1093–1097 Arruda MS, Petta CA, Abrão MS, Benetti-Pinto CL (2003) Time elapsed from onset of symptoms to diagnosis of endometriosis in a cohort study of Brazilian women. Hum Reprod 18(4):756–759 Badri AV, Jennings R, Patel P, Eun DD (2018) Renal endometriosis: the case of an endometrial implant mimicking a renal mass. J Endourol Case Rep 4(1):176–178 Barra F, Scala C, Biscaldi E, Vellone VG, Ceccaroni M, Terrone C et al (2018) Ureteral endometriosis: a systematic review of epidemiology, pathogenesis, diagnosis, treatment, risk of malignant transformation and fertility. Hum Reprod Update 24(6):710–730 Beckman EN, Leonard GL, Pintado SO, Sternberg WH (1985) Endometriosis of the prostate. Am J Surg Pathol 9(5):374–379 Bendifallah S, Roman H, Rubod C, Leguevaque P, Watrelot A, Bourdel N et al (2018) Impact of hospital and surgeon case volume on morbidity in colorectal endometriosis management: a plea to define criteria for expert centers. Surg Endosc 32(4):2003–2011 Berker B, Seval M (2015) Problems with the diagnosis of endometriosis. Womens Health (Lond) 11(5):597–601 Berlanda N, Vercellini P, Carmignani L, Aimi G, Amicarelli F, Fedele L (2009) Ureteral and vesical endometriosis. Two different clinical entities sharing the same pathogenesis. Obstet Gynecol Surv 64:830–842 Berling T, Bolze PA, Berthiller J, Dubernard G, Lamblin G, Paparel P et al (2017) Morbidity and functional long-term follow-up of patients with surgical treatment of urinary tract endometriosis. Gynecol Obstet Fertil Senol 45(6):327–334 Brown J (2017) Nonsteroidal anti-inflammatory drugs for pain in women with endometriosis. Cochrane Database Syst Rev 1:CD004753 Bulun SE (2009) Endometriosis. N Engl J Med 360:268–279 Castaneda CV, Shapiro EY, Ahn JJ, Van Batavia JP, Silva MV, Tan Y et al (2013) Endoscopic management of intraluminal ureteral endometriosis. Urology 82(2):307–312 Ceccaroni M, Ceccarello M, Caleffi G, Clarizia R, Scarperi S, Pastorello M et al (2019) Total laparoscopic ureteroneocystostomy for ureteral endometriosis: a single-center experience of 160 consecutive patients. J Minim Invasive Gynecol 26(1):78–86 Ceccaroni M, Clarizia R, Roviglione G (2020a) Nerve-sparing surgery for deep infiltrating endometriosis: laparoscopic eradication of deep infiltrating endometriosis with rectal and parametrial resection according to the Negrar method. J Minim Invasive Gynecol 27(2):263–264 Ceccaroni M, Ceccarello M, Clarizia R, Fusco E, Roviglione G, Mautone D et al (2020b) Nerve-sparing laparoscopic disc excision of deep endometriosis involving the bowel: a single-center experience on 371 consecutives cases. Surg Endosc. https://doi.org/10.1007/s00464-020-08084-4 Chamié LP, Blasbalg R, Pereira RM, Warmbrand G, Serafini PC (2011) Findings of pelvic endometriosis at transvaginal US, MRI, and laparoscopy. Radiographics 31:E77–E100 Chapron C, Marcellin L, Borghese B, Santulli P (2019) Rethinking mechanisms, diagnosis and management of endometriosis. Nat Rev Endocrinol 15(11):666–682 Charatsi D, Koukoura O, Ntavela IG, Chintziou F, Gkorila G, Tsagkoulis M et al (2018) Gastrointestinal and urinary tract endometriosis: a review on the commonest locations of extrapelvic endometriosis. Adv Med 2018:3461209 Clement PB (2001) History of gynecological pathology. IX. Dr. John Albertson Sampson. 1921. Int J Gynecol Pathol 20:86–101 Clemenza S, Sorbi F, Noci I, Capezzuoli T, Turrini I, Carriero C et al (2018) From pathogenesis to clinical practice: emerging medical treatments for endometriosis. Best Pract Res Clin Obstet Gynaecol 51:92–101 Endo Y, Akatsuka J, Obayashi K, Takeda H, Hayashi T, Nakayama S et al (2020) Efficacy of laparoscopic partial cystectomy with a transurethral resectoscope in patients with bladder endometriosis: see-through technique. Urol Int 104(7-8):546–550 Evans MB, Decherney AH (2017) Fertility and endometriosis. Clin Obstet Gynecol 60(3):497–502 Exacoustos C, De Felice G, Pizzo A, Morosetti G, Lazzeri L, Centini G et al (2018) Isolated ovarian endometrioma: a history between myth and reality. J Minim Invasive Gynecol 25(5):884–891 Fauconnier A, Aubry G, Fritel X (2017) Bladder endometriosis: a rare but challenging condition. Eur Urol 71(5):808–810 Fedele L (1998) Bladder endometriosis: deep infiltrating endometriosis or adenomyosis? Fertil Steril 69:972–975 Ferrero S et al (2015) Treatment of pain associated with deep endometriosis: alternatives and evidence. Fertil Steril 104(4):771–792 Ferrero S, Barra F, RobertiMaggiore UL (2018) Current and emerging therapeutics for the managementof endometriosis. Drugs 78(10):995–1012 Gabriel B, Nassif J, Trompoukis P, Barata S, Wattiez A (2011) Prevalence and management of urinary tract endometriosis: a clinical case series. Urology 78:1269–1274 Garcia-Solares J, Donnez J, Donnez O, Dolmans MM (2018) Pathogenesis of uterine adenomyosis: invagination or metaplasia? Fertil Steril 109(3):371–379 Gezer A, Oral E (2015) Progestin therapy in endometriosis. Womens Health 11(5):643–652 Gordts S, Koninckx P, Brosens I (2017) Pathogenesis of deep endometriosis. Fertil Steril 108(6):872–885.e1 Grasso RF, Di Giacomo V, Sedati P, Sizzi O, Florio G, Faiella E et al (2010) Diagnosis of deep infiltrating endometriosis: accuracy of magnetic resonance imaging and transvaginal 3D ultrasonography. Abdom Imaging 35:716–725 Guerriero S, Condous G, van den Bosch T, Valentin L, Leone FP, Van Schoubroeck D et al (2016) Systematic approach to sonographic evaluation of the pelvis in women with suspected endometriosis, including terms, definitions and measurements: a consensus opinion from the International Deep Endometriosis Analysis (IDEA) group. Ultrasound Obstet Gynecol 48(3):318–332 Guo SW (2009) Recurrence of endometriosis and its control. Hum Reprod Update 15(4):441–461 Haas D, Wurm P, Shamiyeh A, Shebl O, Chvatal R, Oppelt P (2013) Efficacy of the revised Enzian classification: a retrospective analysis. Does the revised Enzian classification solve the problem of duplicate classification in rASRM and Enzian? Arch Gynecol Obstet 287(5):941–945 Hudelist G, Fritzer N, Thomas A, Niehues C, Oppelt P, Haas D et al (2012) Diagnostic delay for endometriosis in Austria and Germany: causes and possible consequences. Hum Reprod 27(12):3412–3416 Hudelist G, Tammaa A, Aas-Eng MK, Kirchner L, Fritzer N, Nemeth Z et al (2018) Outcome of sonography-based minimally invasive surgery for deep infiltrating endometriosis of the ureter and urinary bladder – a retrospective cohort study. Acta Obstet Gynecol Scand 97(3):277–284 Janetschek G (2006) Reconstructive procedures in laparoscopic urology. Urol A 45(9):1127–1128, 1130–1132 Janschek E, Wölfler MM, Zeppernick MM, Meinhold-Herlein I (2020) Medikamentöse Behandlung der Endometriose. Gynäkologe 53(10):658–665 Knabben L, Imboden S, Fellmann B, Nirgianakis K, Kuhn A, Mueller MD (2015) Urinary tract endometriosis in patients with deep infiltrating endometriosis: prevalence, symptoms, management, and proposal for a new clinical classification. Fertil Steril 103:147–152 Koga K et al (2015) Prevention of the recurrence of symptom and lesions after conservative surgery for endometriosis. Fertil Steril 104(4):793–801 Kolodziej A, Urin Krajewski W, Dołowy Ł, Hirnle L (2015) Urinaryary tract endometriosis. Urol J 12(4):2213–2217 Kondo T (2009) Ureteral polypoid endometriosis causing hydroureteronephrosis. Indian J Pathol Microbiol 52(2):246–248 Koninckx PR, Martin DC (1992) Deep endometriosis: a consequence of infiltration or retraction or possibly adenomyosis externa? Fertil Steril 58(5):924–928 Koninckx PR, Ussia A, Adamyan L, Wattiez A, Gomel V, Martin DC (2019) Pathogenesis of endometriosis: the genetic/epigenetic theory. Fertil Steril 111(2):327–340 Konrad L, Dietze R, Kudipudi PK, Horné F, Meinhold-Heerlein I (2019) Endometriosis in MRKH cases as a proof for the coelomic metaplasia hypothesis? Reproduction 158(2):R41–R47 Leonardi M, Espada M, Kho RM, Magrina JF, Millischer AE, Savelli L et al (2020) Endometriosis and the urinary tract: from diagnosis to surgical treatment. Diagnostics (Basel) 10(10):77i-788 Leyendecker G, Wildt L (2011) A new concept of endometriosis and adenomyosis: tissue injury and repair (TIAR). Horm Mol Biol Clin Investig 5(2):125–142 Lusuardi L, Hager M, Sieberer M, Schätz T, Kloss B, Hruby S, Janetschek G (2012) Laparoscopic treatment of intrinsic endometriosis of the urinary tract and proposal of a treatment scheme for ureteral endometriosis. Urology 80(5):1033–1038 Maccagnano C, Pellucchi F, Rocchini L, Ghezzi M, Scattoni V, Montorsi F (2012) Diagnosis and treatment of bladder endometriosis: state of the art. Urol Int 89(3):249–258 Maccagnano C, Pellucchi F, Rocchini L, Ghezzi M, Scattoni V, Montorsi F (2013) Ureteral endometriosis: proposal for a diagnostic and therapeutic algorithm with a review of the literature. Urol Int 91(1):1–9 Maggiore ULR, Ferrero S, Candiani M, Somigliana E, Viganò P, Vercellini P (2017) Bladder endometriosis: a systematic review of pathogenesis, diagnosis, treatment, impact on fertility, and risk of malignant transformation. Eur Urol 71(5):790–807 Nerli RB, Reddy M, Koura AC, Prabha V, Ravish IR, Amarkhed S (2008) Cystoscopy-assisted laparoscopic partial cystectomy. J Endourol 22(1):83–86 Nezhat C et al (2019) Optimal management of endometriosis and pain. Obstet Gynecol 134(4):834–839 Patel BG, Lenk EE, Lebovic DI, Shu Y, Yu J, Taylor RN (2018) Pathogenesis of endometriosis: interaction between endocrine and inflammatory pathways. Best Pract Res Clin Obstet Gynaecol 50:50–60 Piessens S, Edwards A (2020) Sonographic evaluation for endometriosis in routine pelvic ultrasound. J Minim Invasive Gynecol 27(2):265–266 Pinkert TC, Catlow CE, Straus R (1979) Endometriosis of the urinary bladder in a man with prostatic carcinoma. Cancer 43(4):1562–1567 Practice Committee of the American Society for Reproductive Medicine in collaboration with the Society of Reproductive Surgeons. Electronic address: [email protected]; Practice Committee of the American Society for Reproductive Medicine in collaboration with the Society of Reproductive Surgeons (2019) Postoperative adhesions in gynecologic surgery: a committee opinion. Fertil Steril 112(3):458–463 Rehman J, Yildirim G, Khan SA, Chughtai B, Nezhat F (2008) A case of successful laparoscopic resection of adrenal gland endometriosis. Fertil Steril 90(5):2015–2017 Rei C, Williams T, Feloney M (2018) Endometriosis in a man as a rare source of abdominal pain: a case report and review of the literature. Case Rep Obstet Gynecol 2018:2083121 Ruan YQ, Liang WG, Huang SH (2015) Analysis of laparoscopy on endometriosis patients with high expression of CA125. Eur Rev Med Pharmacol Sci 19(8):1334–1337 Sampson JA (1927) Metastatic or embolic endometriosis, due to the menstrual dissemination of endometrial tissue into the venous circulation. Am J Pathol 3(2):93-110.43 Sayasneh A, Tsivos D, Crawford R (2011) Endometriosis and ovarian cancer: a systematic review. Obstet Gynecol 2011:140310 Schrodt GR, Alcorn MO, Ibanez J (1980) Endometriosis of the male urinary system: a case report. J Urol 124(5):722–723 Seracchioli R, Mannini D, Colombo FM, Vianello F, Reggiani A, Venturoli S (2002) Cystoscopy-assisted laparoscopic resection of extramucosal bladder endometriosis. J Endourol 16:663–666 Seracchioli R, Mabrouk M, Montanari G, Manuzzi L, Concetti S, Venturoli S (2010) Conservative laparoscopic management of urinary tract endometriosis (UTE): surgical outcome and long-term follow-up. Fertil Steril 94:856–861 Seracchioli R, Raimondo D, Di Donato N, Leonardi D, Spagnolo E, Paradisi R et al (2015) Histological evaluation of ureteral involvement in women with deep infiltrating endometriosis: analysis of a large series. Hum Reprod 30(4):833–839 Sillou S, Poirée S, Millischer A, Chapron C, Helenon O (2015) Urinary endometriosis: MR imaging appearance with surgical and histological correlations. Diagn Interv Imaging 96:373–381 Somigliana E, Vercellini P, Gattei U, Chopin N, Chiodo I, Chapron C (2018) Bladder endometriosis: getting closer and closer to the unifying metastatic hypothesis. Fertil Steril 87:1287–1290 Symons LK, Miller JE, Kay VR, Marks RM, Liblik K, Koti M, Tayade C (2018) The immunopathophysiology of endometriosis. Trends Mol Med 24(9):748–762 Turco LC, Tortorella L, Tuscano A, Palumbo MA, Fagotti A, Uccella S et al (2020) Surgery-related complications and long-term functional morbidity after segmental colo-rectal resection for deep infiltrating endometriosis (ENDO-RESECT morb). Arch Gynecol Obstet 302(4):983–993 Tuttlies F, Keckstein J, Ulrich U, Possover M, Schweppe KW, Wustlich M et al (2005) Enzian-score, a classification of deep infiltrating endometriosis. Zentralbl Gynakol 127(5):275–281 Ulrich U, Buchweitz O, Greb R, Keckstein J, von Leffern I, Oppelt P, Renner SP, Sillem M, Stummvoll W, De Wilde RL, Schweppe KW (2014) German and Austrian Societies for Obstetrics and Gynecology. National German Guideline (S2k): guideline for the diagnosis and treatment of endometriosis: long version – AWMF registry no. 015-045. Geburtshilfe Frauenheilkd 74(12):1104–1118 Vercellini P, Frontino G, Pisacreta A, De Giorgi O, Cattaneo M, Crosignani PG (2002) The pathogenesis of bladder detrusor endometriosis. Am J Obstet Gynecol 187:538–542 Wang Y, Nicholes K, Shih IM (2020) The origin and pathogenesis of endometriosis. Annu Rev Pathol 15:71–95 Westney OL, Amundsen CL, McGuire EJ (2000) Bladder endometriosis: conservative management. J Urol 163:1814–1817 Yohannes P (2003) Ureteral endometriosis. J Urol 170:20–25 Young S, Burns MK, DiFrancesco L, Nezhat A, Nezhat C (2017) Diagnostic and treatment guidelines for gastrointestinal and genitourinary endometriosis. J Turk Ger Gynecol Assoc 18(4):200–209 Zondervan KT, Becker CM, Missmer SA (2020) Endometriosis. N Engl J Med 382(13):1244–1256 Author information Authors and Affiliations Corresponding author Editor information Editors and Affiliations Section Editor information Rights and permissions Copyright information © 2022 Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature About this entry Cite this entry Janetschek, G., Janschek, E., Heers, H. (2022). Endometriose des Uro-Genitaltraktes. In: Michel, M.S., Thüroff, J.W., Janetschek, G., Wirth, M.P. (eds) Die Urologie. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-41168-7_79-2 Download citation DOI: https://doi.org/10.1007/978-3-642-41168-7_79-2 Received: Accepted: Published: Publisher Name: Springer, Berlin, Heidelberg Print ISBN: 978-3-642-41168-7 Online ISBN: 978-3-642-41168-7 eBook Packages: Living Reference Medizin Publish with us Chapter history - Latest Endometriose des Uro-Genitaltraktes- Published: - 21 September 2022 DOI: https://doi.org/10.1007/978-3-642-41168-7_79-2 - Original Endometriose- Published: - 05 May 2015 DOI: https://doi.org/10.1007/978-3-642-41168-7_79-1

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