Nezhat Ceana H, Malik Shazia, Osias Joelle, Nezhat Farr, Nezhat Camran
Center for Special Pelvic Surgery, Atlanta, Georgia, USA.
Fertil Steril. 2002 Oct;78(4):872-5. doi: 10.1016/s0015-0282(02)03332-0.
To report laparoscopic management of 15 patients with infiltrative bladder wall endometriosis and to report a case of endometrioid adenosarcoma.
Prospective chart review.
Referral center for endometriosis.
PATIENT(S): Fifteen women with infiltrating endometriosis of the bladder.
INTERVENTION(S): Laparoscopic segmental cystectomy and pathologic review of endometriotic bladder nodules in 15 patients.
MAIN OUTCOME MEASURE(S): Location and characteristics of endometriotic bladder nodules.
RESULT(S): Laparoscopic and cystoscopic evaluation confirmed that the endometriotic lesions were penetrating through the bladder wall. In 8 patients, the lesions were located in the dome of the bladder. In the remaining 7, the lesions were in the posterior wall, above the trigone. It was possible to treat all the lesions by performing a laparoscopic partial cystectomy. No intraoperative complications occurred. Deeply infiltrating endometriosis was confirmed on histologic evaluation in 14 cases. One patient was diagnosed with endometriosis on frozen section, but the final pathology revealed an adenosarcoma of the bladder.
CONCLUSION(S): Surgical excision of deeply infiltrating endometriosis of the bladder wall can be performed laparoscopically and offers the benefit of a definitive pathologic diagnosis to rule out an occult malignancy.
报告15例浸润性膀胱壁子宫内膜异位症患者的腹腔镜治疗情况，并报告1例子宫内膜样腺肉瘤病例。
前瞻性病历回顾。
子宫内膜异位症转诊中心。
15例膀胱浸润性子宫内膜异位症女性患者。
对15例患者行腹腔镜节段性膀胱切除术及对子宫内膜异位性膀胱结节进行病理检查。
子宫内膜异位性膀胱结节的位置及特征。
腹腔镜及膀胱镜检查证实子宫内膜异位病变穿透膀胱壁。8例患者病变位于膀胱顶部。其余7例病变位于三角区上方的后壁。通过腹腔镜部分膀胱切除术可治疗所有病变。术中无并发症发生。组织学评估证实14例为深部浸润性子宫内膜异位症。1例患者冰冻切片诊断为子宫内膜异位症，但最终病理显示为膀胱腺肉瘤。
膀胱壁深部浸润性子宫内膜异位症可通过腹腔镜手术切除，且有助于进行明确的病理诊断以排除隐匿性恶性肿瘤。
