Bladder psoas hitch in hydronephrosis due to pelvic endometriosis: outcome of urodynamic parameters.
OBJECTIVE
To evaluate modifications in bladder sensitivity and function after ureteroneocystostomy with bladder psoas hitch for hydronephrosis due to deep pelvic endometriosis.


METHODS
Prospective study.


METHODS
Center for the Treatment of Endometriosis of the Department of Obstetrics and Gynecology of the State University of Milan, Italy.


METHODS
Thirteen patients with deep endometriosis and ureteral involvement. Mean age of patients was 36.8 years (range, 31-48 years).


METHODS
Ureteroneocystostomy with a psoas hitch. Indications for performing psoas hitch ureteroneocystostomy were severe hydronephrosis, radiologic evidence of ureteral stricture measuring >4 cm, and the impossibility of performing ureterolysis.


METHODS
Impact on urodynamic parameters of bladder psoas hitch ureteroneocystostomy.


RESULTS
All patients showed normal bladder capacity 3 months after surgery. Two patients presented with stress incontinence immediately after surgery, which almost completely subsided at 3 months' follow-up. In 4 patients the bladder was also involved; in these cases a bladder resection was performed, followed by ureteral reimplantation. Follow-up was at 6 months from surgery and then every 6 months thereafter, in which patients underwent urogynecologic examination, completed a questionnaire on urinary symptoms, and underwent renal ultrasound evaluation with no evidence of recurrence of obstructive uropathy.


CONCLUSIONS
On the basis of the results of the present study, bladder psoas hitch along with ureteral resection and ureteroneocystostomy for infiltrating endometriosis do not seem to have a negative impact on urodynamic parameters.
Carmignani
Luca
L
Urology Unit, IRCCS Policlinico San Donato, University of Milan, Via Morandi 30, San Donato Milanese, Milan, Italy luca.carmignani@unimi.it
Ronchetti
Antonella
A
Amicarelli
Fabio
F
Vercellini
Paolo
P
Spinelli
Matteo
M
Fedele
Luigi
L
D000328:Adult; D003559:Cystostomy; D004715:Endometriosis / Q000150:complications*; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000209:etiology* / Q000601:surgery*; D008875:Middle Aged; D010298:Parity; D011247:Pregnancy; D011446:Prospective Studies; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery; D001743:Urinary Bladder / Q000601:surgery*; D001745:Urinary Bladder Diseases / Q000209:etiology / Q000601:surgery; D014563:Urodynamics / Q000502:physiology