C.B. Coroleucă1, C. Berceanu2, L. Brindușe3, D. Marcu4, C.A. Coroleucă1, Elvira Brătilă1
1 Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy; “Prof. Dr.Panait Sârbu” Clinical Hospital of Obstetrics and Gynecology, Bucharest, Romania
2 University of Medicine and Pharmacy, Craiova, Romania
3 “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, Department of Public Health and Management
4 Department of Urology, Central Emergency University Military Hospital, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
Corresponding author: Elvira Brătilă, E-mail: elvira.bratila@umfcd.ro
Abstract:
Objective: The goal of this paper is to present the management of cases of deep endometriosis that affects the bladder, the ureters and the kidney.
Materials and method: In this review we analyzed the sensitivity and specificity of imaging techniques for diagnosing deep infiltrating endometriosis, the optimal surgical technique and the surgical approach.
Results: In patients with pelvic endometriosis in advanced stages the urinary tract is frequently involved. Preoperative work-up of patients with deep infiltrating endometriosis is aimed at evaluating the extension of the lesions in order to assess the complexity of the intervention and to choose the optimal approach.
Conclusions: Laparoscopic and robotic management of these cases are good therapeutic alternatives. Ultrasound, sonovaginography with gel and MRI are useful imaging techniques for evaluating patients with deep infiltrating endometriois. The surgical management of patients with deep infiltrating endometriosis that involves the urinary tract consists of partial bladder resections, ureterolysis, ureteral resection and anastomosis and ureteral reimplantation..
Keywords: bladder endometriosis, deep infiltrating endometriosis, ureterolysis
