Endometriosis of the urinary tract in women of reproductive age.
OBJECTIVE
We present our experience with diagnosing and treating 22 cases of urinary tract endometriosis in women of reproductive age.


METHODS
From January 2001 to January 2003, 22 women of reproductive age (mean age 34.8 years) were diagnosed suffering from endometriosis of the urinary tract. We used the Endoscopic Endometriosis Classification (EEC) for assessing the stage of endometriosis.


RESULTS
Endometriosis was present in the bladder, the lower third of the ureter, and in a postnephrectomy ureteral stump in 15 (68.1%), six (27.2%) and one (4.5%) cases, respectively. The EEC classification revealed stages I, II, III and IV in four (18.1%), one (4.5%), one (4.5%), and 16 (72.7%) patients, respectively. Urinary symptoms were present in 14 (63.6%) patients. For the treatment of bladder endometriosis, 10 patients underwent partial cystectomy, while the remaining five patients were treated with transurethral resection. In four patients ureterolysis was performed, by laparoscopy in two cases and by open surgery in the other two cases. Ureterectomy and re-implantation with bladder psoas hitching took place in six patients. In the case of endometriosis of the ureteral stump, open surgical excision took place. During the mean follow-up period of 20 months (range 16-40) no long-term complication or relapse was diagnosed.


CONCLUSIONS
Bladder and ureteral endometriosis should be considered in women of reproductive age with non-specific urinary tract or abdominal symptoms, and surgical treatment is recommended.
Schneider
Andreas
A
Department of Urology, Ammerland Clinics, Westerstede, Germany.
Touloupidis
Stavros
S
Papatsoris
Athanasios G
AG
Triantafyllidis
Argyrios
A
Kollias
Anastasios
A
Schweppe
Karl-Werner
KW
D000328:Adult; D003937:Diagnosis, Differential; D004715:Endometriosis / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012098:Reproduction; D012189:Retrospective Studies; D018666:Ureteroscopy / Q000379:methods*; D014571:Urologic Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D013520:Urologic Surgical Procedures / Q000379:methods