Urinary tract endometriosis treated by laparoscopy.
OBJECTIVE
To evaluate the efficacy of the laparoscopic approach for the diagnosis and treatment of severe urinary tract endometriosis.


METHODS
Retrospective review of 28 cases of severe urinary tract endometriosis.


METHODS
Center for Special Pelvic Surgery, a tertiary referral center.


METHODS
Between October 1989 and September 1994, we treated 28 women who had deeply infiltrating urinary tract endometriosis (bladder, 7, ureter, 21).


METHODS
All procedures were performed laparoscopically.


METHODS
Postoperative urinary function, pain relief, and complications.


RESULTS
Those who had vesical endometriosis underwent partial cystectomy and primary repair. Partial ureteral obstruction was found in 17 women; 10 underwent ureterolysis and excision of endometriosis, and 7 had partial wall resection. Four patients with ureter involvement had complete obstruction. Three underwent partial resection and ureteroureterostomy, and one had ureteroneocystostomy. The rate of ureteral endometriosis in the present series is higher than that reported previously.


CONCLUSIONS
Severe infiltrative endometriosis of the bladder and the ureter can present without specific symptoms and can cause silent compromise of renal function. We demonstrated that the laparoscopic approach is safe and effective in the diagnosis and treatment of this entity.
Nezhat
C
C
Department of Gynecology and Obstetrics, Stanford University School of Medicine, California, USA.
Nezhat
F
F
Nezhat
C H
CH
Nasserbakht
F
F
Rosati
M
M
Seidman
D S
DS
D000328:Adult; D004715:Endometriosis / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014515:Ureteral Diseases / Q000473:pathology / Q000601:surgery*; D001745:Urinary Bladder Diseases / Q000473:pathology / Q000601:surgery*