Laura Knabben1, Sara Imboden2, Bernhard Fellmann2, Konstantinos Nirgianakis2, Annette Kuhn2, Michael D Mueller2. 1. Department of Obstetrics and Gynaecology, University Hospital of Berne and University of Berne, Berne, Switzerland. Electronic address: laura.knabben@insel.ch. 2. Department of Obstetrics and Gynaecology, University Hospital of Berne and University of Berne, Berne, Switzerland.
Abstract
OBJECTIVE: To analyze the prevalence of urinary tract endometriosis (UTE) in patients with deep infiltrating endometriosis (DIE) and to define potential criteria for preoperative workup. DESIGN: Retrospective study. SETTING: University hospital. PATIENT(S): Six hundred ninety-seven patients with endometriosis. INTERVENTION(S): Excision of all endometriotic lesions. MAIN OUTCOME MEASURE(S): Correlation of preoperative features and intraoperative findings in patients with UTE. RESULT(S): Out of 213 patients presenting DIE, 52.6% suffered from UTE. In patients with ureteral endometriosis, symptoms were not specific. Among the patients with bladder endometriosis, 68.8% complained of urinary symptoms compared to 7.9% in the group of patients without UTE. In patients with rectovaginal endometriosis, the probability of ureterolysis showed a linear correlation with the size of the nodule. We found that 3 cm in diameter provided a specific cutoff value for the likelihood of ureteric involvement. CONCLUSION(S): The prevalence of UTE has often been underestimated. Preoperative questioning is important in the search for bladder endometriosis. The size of the nodule is one of the few reliable criteria in preoperative assessment that can suggest ureteric involvement. We propose a classification of ureteral endometriosis that will allow the standardization of terminology and help to compare the outcome of different surgical treatment in randomized studies.
OBJECTIVE: To analyze the prevalence of urinary tract endometriosis (UTE) in patients with deep infiltrating endometriosis (DIE) and to define potential criteria for preoperative workup. DESIGN: Retrospective study. SETTING: University hospital. PATIENT(S): Six hundred ninety-seven patients with endometriosis. INTERVENTION(S): Excision of all endometriotic lesions. MAIN OUTCOME MEASURE(S): Correlation of preoperative features and intraoperative findings in patients with UTE. RESULT(S): Out of 213 patients presenting DIE, 52.6% suffered from UTE. In patients with ureteral endometriosis, symptoms were not specific. Among the patients with bladder endometriosis, 68.8% complained of urinary symptoms compared to 7.9% in the group of patients without UTE. In patients with rectovaginal endometriosis, the probability of ureterolysis showed a linear correlation with the size of the nodule. We found that 3 cm in diameter provided a specific cutoff value for the likelihood of ureteric involvement. CONCLUSION(S): The prevalence of UTE has often been underestimated. Preoperative questioning is important in the search for bladder endometriosis. The size of the nodule is one of the few reliable criteria in preoperative assessment that can suggest ureteric involvement. We propose a classification of ureteral endometriosis that will allow the standardization of terminology and help to compare the outcome of different surgical treatment in randomized studies.
Authors: Stefanie Burghaus; Sebastian D Schäfer; Matthias W Beckmann; Iris Brandes; Christian Brünahl; Radek Chvatal; Jan Drahoňovský; Wojciech Dudek; Andreas D Ebert; Christine Fahlbusch; Tanja Fehm; Peter Martin Fehr; Carolin C Hack; Winfried Häuser; Katharina Hancke; Volker Heinecke; Lars-Christian Horn; Christian Houbois; Christine Klapp; Heike Kramer; Harald Krentel; Jan Langrehr; Heike Matuschewski; Ines Mayer; Sylvia Mechsner; Andreas Müller; Armelle Müller; Michael Müller; Peter Oppelt; Thomas Papathemelis; Stefan P Renner; Dietmar Schmidt; Andreas Schüring; Karl-Werner Schweppe; Beata Seeber; Friederike Siedentopf; Horia Sirbu; Daniela Soeffge; Kerstin Weidner; Isabella Zraik; Uwe Andreas Ulrich Journal: Geburtshilfe Frauenheilkd Date: 2021-04-14 Impact factor: 2.915