Symptomatic bladder or ureteral endometriosis: report of 8 cases and review of the literature

Objectives. - The aim of this study was to determine the symptoms of bladder and ureteral endometriosis and to review the treatment approaches. Materials and Methods. - We conducted a retrospective studyover the period November 1989-July 2000. We reviewed the medical data of all women with bladder or utereral endometriosis who underwent a major surgery (ureteral reimplementation on psoas bladder, partial resection of the ureter, partial cystectomy). Results. - Eight women met the defined selection criterion, three with bladder injury and five with ureteral injury. The only adverse postoperative complication was a passive ureteral reflux following ureteral reimplementation on psoas bladder. No recurrence on the urinary tract were reported. Conclusion. - Surgical treatment is indicated for patient suffering from symptomatic bladder or ureteral endometriosis. Isolated bladder injuries due to endometriosis are mostly treated by laparoscopic surgery. Ureteral endometriosis may deteriorate the renal function. The initial step of the treatment may include an uterolysis by coelioscopy or an ureteral dilatation by ureteroscopy together with a medical treatment. The renal function must be closely monitored. In case of persistent or recurrent endometriosis, an ureteral resection would be justified. (C) 2003 Editions scientifiques et medicales Elsevier SAS. All rights reserved.