Diagnosis and Treatment of Bladder Endometriosis: State of the Art

被引:74
作者
Maccagnano, Carmen [1 ]
Pellucchi, Federico [1 ]
Rocchini, Lorenzo [1 ]
Ghezzi, Massimo [1 ]
Scattoni, Vincenzo [1 ]
Montorsi, Francesco [1 ]
Rigatti, Patrizio [1 ]
Colombo, Renzo [1 ]
机构
[1] Ist Sci San Raffaele, Dept Urol, IT-20132 Milan, Italy
关键词
Urinary tract endometriosis; Bladder endometriosis; Symptoms; Diagnosis; Treatment; DEEPLY INFILTRATING ENDOMETRIOSIS; TERM-FOLLOW-UP; DEPOT MEDROXYPROGESTERONE ACETATE; LAPAROSCOPIC MANAGEMENT; PELVIC ENDOMETRIOSIS; LEUPROLIDE ACETATE; CONSERVATIVE SURGERY; MEDICAL-MANAGEMENT; PAIN SYMPTOMS; DIENOGEST;
D O I
10.1159/000339519
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background: The bladder is the most common affected site in urinary tract endometriosis, being diagnosed during gynecologic follow-up. The surgical urological treatment might lead to good results. Study Objective: To define the state of the art in the diagnosis and treatment of bladder endometriosis. Methods: We performed a literature review by searching the MEDLINE database for articles published between 1996 and 2011, limiting the searches to the words: urinary tract endometriosis, bladder endometriosis, symptoms, diagnosis and treatment. Results: Deep pelvic endometriosis usually involves the urinary system, with the bladder being affected in 85% of cases. The diagnosis has to be considered as a step-by-step procedure. Currently, the treatment is usually surgical, consisting of either transurethral resection or partial cystectomy, and eventually associated with hormonal therapy. The hormonal therapy alone counteracts only the stimulus of endometriotic tissue proliferation, with no effects on the scarring caused by this tissue. The overall recurrence rate is about 30% for combined therapies and about 35% for the hormonal treatment alone. Conclusions: The bladder is the most common affected site in urinary tract endometriosis. Most of the time, this condition is diagnosed because of the complaint of urinary symptoms during gynecologic follow-up procedures for a deep pelvic endometriosis: a close collaboration between the gynecologist and the urologist is advisable, especially in highly specialized centers. The surgical urological treatment might lead to good results in terms of patients' compliance and prognosis. Copyright (C) 2012 S. Karger AG, Basel
引用
收藏
页码:249 / 258
页数:10
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