Conservative laparoscopic management of urinary tract endometriosis (UTE): surgical outcome and long-term follow-up.
OBJECTIVE
To evaluate surgical outcome and long-term follow-up of conservative laparoscopic management of urinary tract endometriosis (UTE).


METHODS
Prospective study.


METHODS
Tertiary-care university hospital.


METHODS
Women with laparoscopic diagnosis and histologic confirmation of urinary bladder or ureteral endometriosis who agreed to undergo long-term follow-up after laparoscopic management.


METHODS
(1) Laparoscopic partial cystectomy for bladder endometriosis. (2) Uretric endometriosis laparoscopically managed by: uretrolysis only; segmental ureterectomy and terminoterminal anastomosis; or segmental ureterectomy and uretrocystoneostomy.


METHODS
Variables assessed were: preoperative findings, operative details (type and site of UTE, type of intervention, perioperative complications), and long-term follow-up (persistence/recurrence of preoperative urinary symptoms, if present, and anatomic relapse of the disease).


RESULTS
Mean operating time was 152.8+/-41.7 minutes. Mean drop in hemoglobin was 1.9+/-1.6 g/dL. Average hospital stay was 6 days. After surgery, 11 women had fever>38 degrees C and four presented transient urinary retention. During a follow-up period of 36 months, endometriosis recurred in eight patients with no evidence of bladder or ureteral reinvolvement, and there was a significant reduction in the mean score of dysuria and suprapubic pain maintained during the whole follow-up period.


CONCLUSIONS
Results of long-term follow-up demonstrate significant reduction in preoperative symptoms with no anatomic relapse.
Seracchioli
Renato
R
Minimally Invasive Gynecologic Surgery Unit, Urology Department, S. Orsola Hospital, University of Bologna, Bologna, Italy. eracchioli@orsola-malpighi.med.unibo.it
Mabrouk
Mohamed
M
Montanari
Giulia
G
Manuzzi
Linda
L
Concetti
Sergio
S
Venturoli
Stefano
S
D000328:Adult; D004715:Endometriosis / Q000150:complications / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D017699:Pelvic Pain / Q000209:etiology / Q000601:surgery; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome; D014570:Urologic Diseases / Q000150:complications / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000379:methods / Q000534:rehabilitation