OBJECTIVES: To perform a comprehensive, up-to-date review of the treatment of all cases of bladder endometriosis published in Spanish language journals in our country, including those published in non-urological scientific journals. METHODS: We identified 28 cases of bladder endometriosis published in the Spanish literature. The treatment performed in each case has been studied, as well as the treatment of relapses and follow-up after definitive treatment. Age and history of caesarean section were registered. RESULTS: Mean patient age was 35 years, with a median of 34 years and limits of 27 and 48. The history of caesarean section is present in 11 cases (39%). Several therapeutic regiments have been followed. Watchful waiting was only undertaken in one case due to the absence of urinary symptoms. Three patients received medical therapy initially. Only one of them had a favourable response. The other two underwent partial cystectomy and transurethral resection (TUR) respectively due to negative response. Transurethral resection was the most frequently used therapeutic modality; it was performed in 19 patients in addition to the aforementioned case. Bladder endometriosis recurred in 7 cases after TUR. Four of these cases underwent partial cystectomy, one of them laparoscopic, and three a second transurethral resection. Partial cystectomy was the initial therapeutic option in 5 cases. 4 of them were open and 1 laparoscopic. No recurrences have been described after partial cystectomy, including those performed for TUR failures. Mean follow-up was 37 months and median follow-up 12 months, being the limits 3 and 192 months. CONCLUSIONS: To date most published cases of bladder endometriosis appear in urologic journals. The most common therapeutic modality is transurethral resection, carried out in 20 cases (71%). However, it is necessary to inform the patient about the chances of treatment failure after TUR, around 35% after this review. Finally, the reported cases treated by laparoscopic partial cystectomy have been published by gynaecologists.
OBJECTIVES: To perform a comprehensive, up-to-date review of the treatment of all cases of bladder endometriosis published in Spanish language journals in our country, including those published in non-urological scientific journals. METHODS: We identified 28 cases of bladder endometriosis published in the Spanish literature. The treatment performed in each case has been studied, as well as the treatment of relapses and follow-up after definitive treatment. Age and history of caesarean section were registered. RESULTS: Mean patient age was 35 years, with a median of 34 years and limits of 27 and 48. The history of caesarean section is present in 11 cases (39%). Several therapeutic regiments have been followed. Watchful waiting was only undertaken in one case due to the absence of urinary symptoms. Three patients received medical therapy initially. Only one of them had a favourable response. The other two underwent partial cystectomy and transurethral resection (TUR) respectively due to negative response. Transurethral resection was the most frequently used therapeutic modality; it was performed in 19 patients in addition to the aforementioned case. Bladder endometriosis recurred in 7 cases after TUR. Four of these cases underwent partial cystectomy, one of them laparoscopic, and three a second transurethral resection. Partial cystectomy was the initial therapeutic option in 5 cases. 4 of them were open and 1 laparoscopic. No recurrences have been described after partial cystectomy, including those performed for TUR failures. Mean follow-up was 37 months and median follow-up 12 months, being the limits 3 and 192 months. CONCLUSIONS: To date most published cases of bladder endometriosis appear in urologic journals. The most common therapeutic modality is transurethral resection, carried out in 20 cases (71%). However, it is necessary to inform the patient about the chances of treatment failure after TUR, around 35% after this review. Finally, the reported cases treated by laparoscopic partial cystectomy have been published by gynaecologists.
Authors: Héctor Pastor-Navarro; José M Giménez-Bachs; María J Donate-Moreno; José M Pastor-Guzman; Rafael Ruíz-Mondéjar; Manuel Atienzar-Tobarra; Antonio S Salinas-Sánchez; Julio A Virserda-Rodriguez Journal: Int Urogynecol J Pelvic Floor Dysfunct Date: 2007-03-15