Urinary tract endometriosis in patients with deep infiltrating endometriosis: prevalence, symptoms, management, and proposal for a new clinical classification

Knabben, Laura Michelle Tatjana; Imboden, Sara; Fellmann, Bernhard; Nirgianakis, Konstantinos; Kuhn, Annette; Mueller, Michael (2015). Urinary tract endometriosis in patients with deep infiltrating endometriosis: prevalence, symptoms, management, and proposal for a new clinical classification. Fertility and sterility, 103(1), pp. 147-152. Elsevier 10.1016/j.fertnstert.2014.09.028

Text 1-s2.0-S0015028214022055-main_25439849.pdf - Published Version Restricted to registered users only Available under License Publisher holds Copyright. Download (338kB)

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.

Interest & Impact

Downloads

2 since deposited on 31 Mar 2016
0 in the past 12 months

Citations

5 Citations in Web of Science ®
6 Citations in Scopus

Search

in Google Scholar™

Services

Actions (login required)

Edit item

Actions (login required)

Edit item