Tisserand B, Pirès C, Ouaki F, Orget J, Leremboure H, Briffaux R, Irani J, Doré B
Service d'urologie, CHU Jean-Bernard, 2, rue de la Milétrie, 86000 Poitiers, France.
Prog Urol. 2009 Dec;19(11):850-7. doi: 10.1016/j.purol.2009.03.003. Epub 2009 May 5.
Our study aimed at evaluating, retrospectively, the outcome of the surgical management of urinary tract endometriosis.
Twelve women with a mean age of 36,4 were recruited between 1994 and 2007. They all had a histologically-proven and surgically-treated endometriosis of the urinary tract.
Seven of them had a unilateral ureteric localization, two had a bilateral ureteric localization and three had a vesical localization. One patient with bladder nodules underwent a partial cystectomy and the two other patients with bladder localization underwent a transurethral resection. Out of the nine patients who had a ureteric localization of endometriosis, seven had a ureterectomy and re-implantation with bladder psoas hitching and had no recurrence.
Our experience showed that ureterectomy and re-implantation with bladder psoas hitching is probably the best way of preventing recurrences in the case of urethral endometriosis. In the case of bladder endometriosis, transurethral resection did not appear as the most effective treatment although it remains an acceptable alternative, especially as far as premenopausal women or young women wishing to conceive are concerned.
我们的研究旨在回顾性评估尿路子宫内膜异位症手术治疗的结果。
1994年至2007年间招募了12名平均年龄为36.4岁的女性。她们均患有经组织学证实且接受过手术治疗的尿路子宫内膜异位症。
其中7例为单侧输尿管定位，2例为双侧输尿管定位，3例为膀胱定位。1例膀胱结节患者接受了部分膀胱切除术，另外2例膀胱定位患者接受了经尿道切除术。在9例输尿管定位的子宫内膜异位症患者中，7例行输尿管切除术并膀胱腰大肌悬吊再植术，且无复发。
我们的经验表明，对于尿道子宫内膜异位症，输尿管切除术并膀胱腰大肌悬吊再植术可能是预防复发的最佳方法。对于膀胱子宫内膜异位症，经尿道切除术似乎并非最有效的治疗方法，尽管它仍是一种可接受的选择，尤其是对于绝经前女性或希望怀孕的年轻女性而言。
