Unit of Oncologic Minimally Invasive and Andrology, Department of Experimental and Clinical Medicine (Drs. Maida, Lambertini, Grosso, Mari, and Minervini).
Unit of Oncologic Minimally Invasive and Andrology, Department of Experimental and Clinical Medicine (Drs. Maida, Lambertini, Grosso, Mari, and Minervini).
J Minim Invasive Gynecol. 2022 Oct;29(10):1178-1183. doi: 10.1016/j.jmig.2022.07.004. Epub 2022 Jul 9.
To investigate the clinical and surgical predictors of urinary tract endometriosis (UTE) relapse.
Retrospective single institutional study.
Italian multidisciplinary referral center for endometriosis.
Consecutive patients affected by UTE and surgically treated between January 2016 and March 2020.
Surgical excision for UTE. Uni- and multivariate logistic regression analyses were fitted to evaluate clinical and surgical predictors of recurrence.
A total of 105 female age-reproductive patients were enrolled. Median age was 32 years (interquartile range, 24-37). Ureteral involvement was recorded in 53 patients (50.5%), being unilateral and bilateral in 46 patients (43.8%) and 7 patients (6.7%), respectively. Bladder involvement occurred in 52 patients (49.5%). Open surgical approach was performed in 24 cases (22.9%), whereas 30 patients (28.5%) and 51 patients (48.6%) were treated with laparoscopic and robot-assisted approach, respectively. Overall, 53 patients (50.5%) received adjuvant hormonal therapy. At a median follow-up of 39 months (interquartile range, 22-51), 30 patients (28.6%) experienced disease relapse, with 14 recurrences (13.3%) recorded at the level of the urinary tract. At multivariable analysis, age at first surgery <25 years (odds ratio [OR], 1.23; 95% confidence interval [CI], 1.10-1.84; p = .02) and the presence of a concomitant autoimmune disease (OR, 1.45; 95% CI, 1.24-2.17; p = .02) were found as predictors of deep infiltrating endometriosis recurrence, whereas adjuvant postsurgical therapy showed a protective role (OR, 0.83; 95% CI, 0.53-0.98; p = .01).
Young age (<25 years) and the presence of autoimmune diseases were significant predictors for the development of disease recurrence, whereas adjuvant hormonal therapy showed a protective role.
探究尿路子宫内膜异位症（UTE）复发的临床和手术预测因素。
回顾性单机构研究。
意大利子宫内膜异位症多学科转诊中心。
2016 年 1 月至 2020 年 3 月连续就诊且接受手术治疗的 UTE 患者。
UTE 的手术切除。采用单因素和多因素逻辑回归分析来评估复发的临床和手术预测因素。
共纳入 105 名年龄在生育期的女性患者。中位年龄为 32 岁（四分位距 24-37）。53 名患者（50.5%）存在输尿管受累，其中 46 名（43.8%）和 7 名（6.7%）患者为单侧和双侧受累。52 名患者（49.5%）存在膀胱受累。24 例（22.9%）采用开放手术方式，30 例（28.5%）和 51 例（48.6%）分别采用腹腔镜和机器人辅助手术方式。总体而言，53 名患者（50.5%）接受了辅助激素治疗。中位随访 39 个月（四分位距 22-51）时，30 名患者（28.6%）发生疾病复发，其中 14 名（13.3%）在尿路水平复发。多变量分析显示，初次手术年龄<25 岁（比值比[OR]，1.23；95%置信区间[CI]，1.10-1.84；p=0.02）和同时存在自身免疫性疾病（OR，1.45；95%CI，1.24-2.17；p=0.02）是深部浸润性子宫内膜异位症复发的预测因素，而术后辅助治疗则表现出保护作用（OR，0.83；95%CI，0.53-0.98；p=0.01）。
年轻（<25 岁）和存在自身免疫性疾病是疾病复发的显著预测因素，而辅助激素治疗则表现出保护作用。
