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Deep endometriosis inflicting the bladder: long-term outcomes of surgical management

  • General Gynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objective

To assess the efficacy and safety of laparoscopic treatment of bladder endometriosis, especially in cases of full thickness endometriotic nodules.

Design

Retrospective review of medical records.

Setting

Tertiary medical center and a referral center for endometriosis.

Population

Sixty-nine patients with bladder endometriosis that underwent surgery between January 2005 and December 2011.

Methods

The records of all patients with bladder endometriosis were reviewed and the pre-, intra- and postoperative information of patients who underwent surgery was collected.

Main outcome measures

Efficacy, safety and long-term outcome of laparoscopic treatment of bladder endometriosis.

Results

The mean age of 69 patients with bladder endometriosis was 31.3 ± 4.6 years. Preoperative urinary symptoms (such as frequency, urgency, dysuria and others) were present in 28 (40.0 %) patients. Laparoscopy was performed in all patients. Deep detrusor involvement was found in 45 (65.2 %) patients. Of these, 21 patients underwent partial cystectomy due to a full thickness lesion. Deep nodule resection without bladder invasion was performed in 24 (34.8 %) patients and bladder nodule coagulation and ablation in the remaining 24 (34.8 %) patients with superficial involvement. No intraoperative complications were noted. Postoperative follow-up results were available for all patients. After a median (range) follow-up period of 60 (4–92) months, 92.7 % of the patients were asymptomatic or reported improvement in symptoms.

Conclusions

After a long-term follow-up surgical management of bladder endometriosis is strongly recommended. During surgery, careful inspection and full excision of bladder lesions should be performed. Laparoscopic excision is a safe and efficacies approach.

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Conflict of interest

All authors state that they have no potential conflicts of interest.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, affiliated to Tel-Aviv University, 52621, Ramat-Gan, Israel

    Ron Schonman, Adi Y. Weintraub, Guy Bibi, Vered H. Eisenberg, Daniel S. Seidman, Mordechai Goldenberg & David Soriano

  2. Department of Urology, Sheba Medical Center, Tel-Hashomer, affiliated to Tel-Aviv University, Ramat-Gan, Israel

    Zohar Dotan

  3. Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel

    Adi Y. Weintraub

Authors
  1. Ron Schonman
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  2. Zohar Dotan
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  3. Adi Y. Weintraub
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  4. Guy Bibi
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  5. Vered H. Eisenberg
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  6. Daniel S. Seidman
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  7. Mordechai Goldenberg
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  8. David Soriano
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Corresponding author

Correspondence to David Soriano.

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Schonman, R., Dotan, Z., Weintraub, A.Y. et al. Deep endometriosis inflicting the bladder: long-term outcomes of surgical management. Arch Gynecol Obstet 288, 1323–1328 (2013). https://doi.org/10.1007/s00404-013-2917-6

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  • DOI: https://doi.org/10.1007/s00404-013-2917-6

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