Open AccessDiagnosis and management of cases with deep infiltrating endometriosis affecting the urinary tract
Author(s) -
C.B. Coroleucă,
C. Berceanu,
L. Brindușe,
D. Marcu,
Elvira Brătilă
Publication year - 2018
Publication title -
romanian journal of military medicine
Language(s) - English
Resource type - Journals
eISSN - 2501-2312
pISSN - 1222-5126
DOI - 10.55453/rjmm.2018.121.3.4
Subject(s) - medicine , endometriosis , ureterolysis , urinary system , anastomosis , laparoscopy , pelvic pain , radiology , surgery , urology , hydronephrosis
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.