Nezhat C, Nezhat F, Nezhat C H, Nasserbakht F, Rosati M, Seidman D S
Department of Gynecology and Obstetrics, Stanford University School of Medicine, California, USA.
Fertil Steril. 1996 Dec;66(6):920-4.
To evaluate the efficacy of the laparoscopic approach for the diagnosis and treatment of severe urinary tract endometriosis.
Retrospective review of 28 cases of severe urinary tract endometriosis.
Center for Special Pelvic Surgery, a tertiary referral center.
PATIENT(S): Between October 1989 and September 1994, we treated 28 women who had deeply infiltrating urinary tract endometriosis (bladder, 7, ureter, 21).
INTERVENTION(S): All procedures were performed laparoscopically.
MAIN OUTCOME MEASURE(S): Postoperative urinary function, pain relief, and complications.
RESULT(S): Those who had vesical endometriosis underwent partial cystectomy and primary repair. Partial ureteral obstruction was found in 17 women; 10 underwent ureterolysis and excision of endometriosis, and 7 had partial wall resection. Four patients with ureter involvement had complete obstruction. Three underwent partial resection and ureteroureterostomy, and one had ureteroneocystostomy. The rate of ureteral endometriosis in the present series is higher than that reported previously.
CONCLUSION(S): Severe infiltrative endometriosis of the bladder and the ureter can present without specific symptoms and can cause silent compromise of renal function. We demonstrated that the laparoscopic approach is safe and effective in the diagnosis and treatment of this entity.
评估腹腔镜手术在诊断和治疗重度泌尿道子宫内膜异位症中的疗效。
对28例重度泌尿道子宫内膜异位症病例进行回顾性研究。
三级转诊中心——特殊盆腔手术中心。
1989年10月至1994年9月期间，我们治疗了28例患有深度浸润性泌尿道子宫内膜异位症的女性（膀胱7例，输尿管21例）。
所有手术均通过腹腔镜进行。
术后排尿功能、疼痛缓解情况及并发症。
膀胱子宫内膜异位症患者接受了部分膀胱切除术及一期修复。17例女性发现有部分输尿管梗阻；10例行输尿管松解术及子宫内膜异位症切除术，7例行部分输尿管壁切除术。4例输尿管受累患者出现完全梗阻。3例行部分切除术及输尿管输尿管吻合术，1例行输尿管膀胱吻合术。本系列中输尿管子宫内膜异位症的发生率高于先前报道。
膀胱和输尿管的重度浸润性子宫内膜异位症可能无特异性症状，并可导致肾功能的隐匿性损害。我们证明腹腔镜手术在诊断和治疗该疾病方面是安全有效的。
