This was a retrospective analysis of 656 women with endometriosis, between January 2005 and August 2016, in a large single academic center. From this cohort, the authors identified a group of 28 (4.3%) patients, with a mean age of 38 ± 6.9 years at diagnosis, who underwent minor or major surgery due to UTE.
Of the 28 patients, only 4 patients (14.3%) were asymptomatic with the most common symptom being lumbar pain, manifesting in 50% of the patients. The mean endometrial lesion size was 2.8 ± 1.7 cm, involving the ureter in 13 patients (46.4%), the bladder in 11 patients (39.3%) and both in the remaining 4 patients (14.3%) patients. The left ureter was the most commonly involved genitourinary organ (35.7%). Hydronephrosis was detected in 18 patients (64.3%) and 12 patients (42.9%) consequently endured some renal function impairment.
Minor surgeries were performed in 12 (42.9%) patients, including TUR, double-J stenting or percutaneous nephrolithotomy, and ureteroscopy. Major surgeries included distal ureterectomy, nephrectomy, and open/laparoscopic excision of endometriomas. Each patient had on average 1.79 ± 1.3 surgeries, and overall 11 patients (39.3%) had more than one surgery. Mean hospitalization time was 6.3 ± 7.4 days. With a mean follow-up of 36.3 months, none of the patients with bladder involvement had a recurrence.
In conclusion, despite being a histologically benign pathology, deep infiltrating endometriosis can have significant consequences affecting the genitourinary tract, likely leading to multiple procedures with a risk of renal function loss. Surgical treatment is highly successful in most cases.
Speaker: Maria José Freire, Coimbra, Portugal
Written By: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre
at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA