Department of Gynaecologic and Oncologic Surgery and Obstetrics, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Université Lyon 1, France.
Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Faculté de Médecine Sorbonne Université, Institut Universitaire de Cancérologie (IUC), France.
Eur J Obstet Gynecol Reprod Biol. 2021 Sep;264:155-161. doi: 10.1016/j.ejogrb.2021.06.018. Epub 2021 Jun 16.
To review prospectively the clinical characteristics of patients suffering from urinary tract endometriosis (UTE) in France, in 2017.
We conducted a prospective observational multicenter study including women managed surgically for UTE in 31 French endometriosis expert centers (FRIENDS group) from January 1, 2017 to December 31, 2017. We distinguished patient with isolated bladder endometriosis ("IBE") or isolated ureteral endometriosis ("IUE") and patients associating both locations (mixed locations "ML"). Surgeons belonging to FRIENDS group enrolled patients by filling a 24 items questionnaire the day of the surgery and 6 weeks later. Data on the locations of UTE, preoperative assessment, urinary symptoms and associated pelvic locations were collected in a single anonymized database.
A total of 232 patients from 31 centers were included. IBE concerned 82 patients (35.3%), IUE 126 patients (54.4%) ML 24 patients (10.3%). 111 patients reported urinary symptoms (47.8%). IUE was more often asymptomatic than the rest of the locations (59.5% versus 43.3%, OR 1,92, p = 0.017). Associated deep infiltrating endometriosis (DIE) lesions were found in 193 patients (83.1%). IUE was significantly associated with other DIE lesions (82.5% versus 66%, OR2.4, p = 0.006), particularly with rectum or sigmoid nodules (57.1% versus 36.8%, OR 2.3, p = 0.002) and retrocervical space nodules (31.7% versus 19.8%, OR 1.9, p = 0.05).
Our study reports the second largest series of patients operated from a UTE and shows that ureteral location seems more frequent, less symptomatic and more frequently associated to other DIE locations than bladder endometriosis.
回顾 2017 年法国患有尿路子宫内膜异位症（UTE）患者的临床特征。
我们进行了一项前瞻性观察性多中心研究，纳入了 2017 年 1 月 1 日至 12 月 31 日期间在 31 个法国子宫内膜异位症专家中心（FRIENDS 组）接受手术治疗的 UTE 患者。我们区分了单纯膀胱子宫内膜异位症（“IBE”）或单纯输尿管子宫内膜异位症（“IUE”）和同时累及两个部位的患者（混合部位“ML”）。FRIENDS 组的外科医生在手术当天和 6 周后通过填写 24 项问卷来招募患者。UTE 的位置、术前评估、泌尿道症状和相关盆腔位置的数据被收集在一个单一的匿名数据库中。
共纳入 31 个中心的 232 名患者。IBE 涉及 82 名患者（35.3%），IUE 涉及 126 名患者（54.4%），ML 涉及 24 名患者（10.3%）。111 名患者报告有泌尿道症状（47.8%）。IUE 无症状的比例高于其他部位（59.5%比 43.3%，OR 1.92，p=0.017）。193 名患者（83.1%）存在深部浸润性子宫内膜异位症（DIE）病变。IUE 与其他 DIE 病变显著相关（82.5%比 66%，OR 2.4，p=0.006），特别是与直肠或乙状结肠结节（57.1%比 36.8%，OR 2.3，p=0.002）和宫颈后间隙结节（31.7%比 19.8%，OR 1.9，p=0.05）。
本研究报告了第二大系列接受 UTE 手术的患者，结果表明输尿管部位比膀胱子宫内膜异位症更常见，症状更少，且更常与其他 DIE 部位相关。
