Surgical treatment for infiltrating endometriosis of the urinary tract


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Abstract

The incidence of urinary tract endometriosis has recently increased from 0.3 to 12%. Objective. To study the specific features of surgical treatment for urinary tract endometriosis. Subject and methods. 61 patients were examined and surgically treated at the V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology for infiltrating endometriosis involving the urinary tract. They were divided into two groups. Group 1 consisted of 23 patients with infiltrating endometriosis of the urinary tract who had sought medical advice for this disease for the first time. Group 2 included 38 patients with this condition who had been previously treated for endometriosis. The patient examination encompassed history data collection and complaint detailing, gynecological and somatic history data study, physical examinations, special gynecological examination, and special techniques (transvaginal ultrasonography, ultrasonography of abdominal organs, kidneys, and bladder, small pelvic magnetic resonance imaging, cystoscopy), and statistical methods. Results. Laparoscopic and laparotomic approaches were applied to 40 (65.6%) and 12 (19.7%) patients, respectively; conversion was done in 9 (14.7%) patients. Ureterolysis was carried out in 30 (49.1%) patients; bladder endometrioid infiltration was excised in 22 (36%); cystectomy was performed in 18 (29.5%), cystoscopy in 25 (41%), ureteric catheterization in 12 (19.6%), nephrectomy in 2 (3.5), and ureteral orifice resection and cystoureteral neostomy in 1 (1.6%) patient. The operated organs of the urinary tract showed no complications. Conclusion. Urinary tract endometriosis is rarely encountered; however, patients with this disease deserve meticulous attention. Patients with infiltrating endometriosis of the urinary tract need surgery. Operations for urinary tract endometriosis are technically difficult and require that a surgical team should have definite experience and skills.

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About the authors

Anna Martunovna Khachatryan

I.M. Sechenov First Moscow State Medical University

Email: a_hachatryan@oparina4.ru
Postgraduate Student, Department of Obstetrics, Gynecology, Perinatology, and Reproductology, Faculty for Postgraduate Professional Training of Physicians

Vladimir Dmitrievich Chuprynin

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: v_chuprynin@oparina4.ru
PhD, Head of the Department of General Surgery

Elena Grigorevna Khilkevich

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia; I.M. Sechenov First Moscow State Medical University

Email: e_khilkevich@oparina4.ru
eading researcher of General Surgery; professor of Department of Obstetrics, Gynecology, Perinatology and Reproductive

Mikhail Viktorovich Melnikov

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Candidate of Medical Sciences, Head in Clinical Work, Department of Surgery

Aleksander Iosifovich Gus

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: a_gus@oparina4.ru
MD, professor, the leader of the department of functional diagnostics department of diagnostic imaging

Stanislav Vladislavovich Pavlovich

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: stpavlovich@mail.ru
MD, PhD, Secretary

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