Surgical management of urinary tract endometriosis
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According to a study by The Journal of Minimally Invasive Gynecology, the surgical management of ureteral and bladder endometriosis is generally feasible and safe through laparoscopic surgery.

The study objective was to describe the surgical management and the risks of postoperative complications of patients suffering from urinary tract endometriosis (UTE) in France in 2017.

All women managed surgically for UTE were enrolled. Investigators distinguished patients with isolated bladder endometriosis (IBE) or isolated ureteral endometriosis (IUE) and patients associating both locations (mixed locations, ML). A total of 232 patients from 31 centers were included. IBE was found in 82 patients, IUE in 126 patients ML in 24 patients.

--Surgery was performed by laparoscopy, laparotomy, or robot-assisted laparoscopy in 74.1%, 11.2%, and 14.7% of cases respectively.

--Among the 150 ureteral lesions (IUE and ML), 114 were managed with ureterolysis, 28 with ureteral resections, 4 with nephrectomies, and 23 with cystectomies.

--Concerning bladder endometriosis, a partial cystectomy was performed in 94.3% of cases.

--They reported 61 postoperative complications, 44 low-grade complications according to the Clavien-Dindo classification, 16 grade III complications, and one grade IV complication.

In conclusion, the surgical management of ureteral and bladder endometriosis is usually feasible and safe through laparoscopic surgery. Ureteral resection, when necessary, is more strongly associated with laparotomy and with more complications compared to other procedures.

Source: https://doi.org/10.1016/j.jmig.2021.04.020
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