Acker O, Robert Y, Carpentier F, Vinatier D, Cosson M
Service de gynécologie obstétrique, centre hospitalier de Roubaix, pavillon Paul-Gelle, 91, avenue J.-Lagache, BP 359, 59056 Roubaix cedex 1, France.
Ann Chir. 2003 Feb;128(1):34-9. doi: 10.1016/s0003-3944(02)00010-x.
The aim of this study was to determine the symptoms of bladder and ureteral endometriosis and to review the treatment approaches.
We conducted a retrospective studyover the period November 1989-July 2000. We reviewed the medical data of all women with bladder or utereral endometriosis who underwent a major surgery (ureteral reimplementation on psoas bladder, partial resection of the ureter, partial cystectomy).
Eight women met the defined selection criterion, three with bladder injuryand five with ureteral injury. The only adverse postoperative complication was a passive ureteral reflux following ureteral reimplementation on psoas bladder. No recurrence on the urinary tract were reported.
Surgical treatment is indicated for patient suffering from symptomatic bladder or ureteral endometriosis. Isolated bladder injuries due to endometriosis are mostly treated by laparoscopic surgery. Ureteral endometriosis may deteriorate the renal function. The initial step of the treatment may include an uterolysis by coelioscopy or an ureteral dilatation by ureteroscopy together with a medical treatment. The renal function must be closely monitored. In case of persistent or recurrent endometriosis, an ureteral resection would be justified.
本研究旨在确定膀胱和输尿管子宫内膜异位症的症状，并回顾其治疗方法。
我们进行了一项回顾性研究，研究时间为1989年11月至2000年7月。我们回顾了所有接受大手术（腰大肌膀胱输尿管再植术、输尿管部分切除术、膀胱部分切除术）的膀胱或输尿管子宫内膜异位症女性的医疗数据。
8名女性符合确定的入选标准，3例膀胱损伤，5例输尿管损伤。术后唯一的不良并发症是腰大肌膀胱输尿管再植术后的被动性输尿管反流。未报告泌尿系统复发情况。
有症状的膀胱或输尿管子宫内膜异位症患者需进行手术治疗。子宫内膜异位症导致的孤立性膀胱损伤大多通过腹腔镜手术治疗。输尿管子宫内膜异位症可能会损害肾功能。治疗的第一步可能包括通过腹腔镜进行子宫松解术或通过输尿管镜进行输尿管扩张术并辅以药物治疗。必须密切监测肾功能。如果子宫内膜异位症持续或复发，输尿管切除术是合理的。
