The Journal of Minimally Invasive Gynecology
Volume 17, Issue 5 , Pages 600-604, September 2010

Endometriosis of Bladder: Outcomes after Laparoscopic Surgery

IRCAD (Research Institute Against Digestive Cancer) and University Hospitals Strasbourg (Hautepierre Hospital and CMCO [Centre Medico-Chirurgical et Obstetrical] Hospital), Strasbourg, France

Received 4 March 2010; accepted 19 May 2010. published online 26 July 2010.

Abstract 

Study Objective

To describe outcomes after laparoscopic excision of deep bladder endometriosis.

Design

Retrospective study (Canadian Task Force classification II-3).

Setting

University hospitals.

Patients

Twenty-one consecutive patients with endometriotic nodule on the bladder (infiltrating detrusor muscle) from a series of 169 patients were included in the study. The primary outcome studied was resolution of bladder symptoms. Secondary outcomes included complication rates, recurrence rates, and pregnancy rates after laparoscopic surgery.

Interventions

Laparoscopic excision of bladder endometriosis.

Measurements and Main Results

Laparoscopy was feasible in all cases without the need for conversion. Median follow-up was 20 months. Ten patients (47.6%) underwent partial cystectomy, and the remaining patients underwent partial-thickness excision of the detrusor muscle. Sixteen patients (76%) had associated deep lesions in the pelvis. The most common associated lesions were rectovaginal nodules (38%) and ureteric lesions (14%), with signs of obstruction. Major complications developed in 3 patients (14%), primarily related to bowel resection. Six patients became pregnant (60%). No patients experienced disease recurrence.

Conclusion

Laparoscopic excision is feasible in all types of bladder endometriosis but often involves multiple procedures to manage associated lesions, especially rectovaginal nodules and ureteric lesions. Previous reports have suggested that ureteric lesions are not associated with bladder endometriosis; however, this was not true in our series. Complications are primarily related to severity of the disease and associated procedures. Partial cystectomy is not required in all cases to achieve adequate clearance. Complete excision of the disease is associated with resolution of bladder symptoms and low recurrence rates.

Keywords: Bladder, Endometriosis, Laparoscopy, Partial cystectomy

To access this article, please choose from the options below

Login to an existing account or Register a new account.

  • Purchase this article for 31.50 USD (You must login/register to purchase this article)

    Online access for 24 hours. The PDF version can be downloaded as your permanent record.

  • Subscribe to this title

    Get unlimited online access to this article and all other articles in this title 24/7 for one year.

  • Claim access now

    For current subscribers with Society Membership or Account Number.

  • Visit SciVerse ScienceDirect to see if you have access via your institution.
 

 The authors have no commercial, proprietary, or financial interest in the products or companies described in this article.

PII: S1553-4650(10)00245-1

doi:10.1016/j.jmig.2010.05.008

The Journal of Minimally Invasive Gynecology
Volume 17, Issue 5 , Pages 600-604, September 2010