The role of the robot in treating urinary tract endometriosis

Nezhat, Camran; Modest, Anna M.; King, Louise P.

doi:10.1097/gco.0b013e3283630dfc

Cited by 12 publications

(8 citation statements)

References 30 publications

(42 reference statements)

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“…The most common sites of urinary tract endometriosis are the bladder, ureter, and kidneys, with a ratio of 40:5:1, respectively ( 67 , 68 , 69 ). Ureteral endometriosis can be difficult to diagnose because it is asymptomatic in over 50% of patients ( 70 , 71 , 72 ).…”

Section: Ureteral Endometriosismentioning

confidence: 99%

“…Laparoscopic treatment of endometriosis with complete excision of fibrotic lesions is the treatment of choice ( 67 , 71 , 78 , 79 , 80 , 81 , 82 , 83 ). VALRA offers numerous advantages over laparotomy, in particular improved visualization and magnification of endometriotic lesions, less blood loss, and less adhesion formation.…”

Section: Ureteral Endometriosismentioning

confidence: 99%

“…A larger distance may require a Boari flap, ileal interposition, or autotransplantation ( 78 ). Lesions in the middle or upper third of the ureter may require a ureteroureteral anastomosis ( 67 , 70 , 78 , 84 ). It is important to ensure that all anastomoses remain free of tension to prevent leakage and fistula formation ( 83 ).…”

Section: Ureteral Endometriosismentioning

confidence: 99%

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Diagnostic and treatment guidelines for gastrointestinal and genitourinary endometriosis

Young¹,

Burns²,

DiFrancesco³

et al. 2017

J Turkish German Gynecol Assoc

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Endometriosis is commonly misdiagnosed, even among many experienced gynecologists. Gastrointestinal and genitourinary endometriosis is particularly difficult to diagnose, and is commonly mistaken for other pathologies, such as irritable bowel syndrome, interstitial cystitis, and even psychological disturbances. This leads to delays in diagnosis, mismanagement, and unnecessary testing. In this review, we will discuss the diagnosis and management of genitourinary and gastrointestinal endometriosis. Medical management may be tried first, but often fails in cases of urinary tract endometriosis. This is particularly important in cases of ureteral endometriosis because silent obstruction can lead to eventual kidney failure. Thus, we recommend complete surgical treatment in these cases. Bladder endometriosis may be managed more conservatively, and only if symptomatic, because these rarely lead to significant morbidity. In cases of bowel endometriosis, we recommend medical management first in all cases, and the least invasive surgical management only if medical treatment fails. This is due to the extensive nervous and vasculature supply to the lower rectum. Injury to these nerves and vessels can cause significant complications and postoperative morbidity.

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Section: Ureteral Endometriosismentioning

confidence: 99%

Section: Ureteral Endometriosismentioning

confidence: 99%

Section: Ureteral Endometriosismentioning

confidence: 99%

See 1 more Smart Citation

Diagnostic and treatment guidelines for gastrointestinal and genitourinary endometriosis

Young¹,

Burns²,

DiFrancesco³

et al. 2017

J Turkish German Gynecol Assoc

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“…However, with the advent of the da Vinci robotic system, robot-assisted surgery in gynecology has overcome certain limits of conventional laparoscopy (CL), such as complex sutures and deep infiltrating endometriosis dissection [4]. In the infiltrating endometriosis (bowel, bladder, and urethral endometriosis), numerous clinical trials reported robot-assisted laparoscopy (RAL) has superior advantages [5][6][7][8] and offered excellent outcomes with no doubt. However fewer publications reported the compar-ison of the treatment of advanced stage endometriosis, respectively, by RAL and CL.…”

Section: Introductionmentioning

confidence: 99%

Robot-assisted versus conventional laparoscopic surgery in the treatment of advanced stage endometriosis: a meta-analysis

Chen¹,

Li²,

Du³

2016

Clin. Exp. Obstet. Gynecol.

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RAL in the treatment of advanced stage endometriosis between 2008 and 2015 have been reviewed. Some search terms, such as "robotic", "laparoscopic", "endometriosis" "severe endometriosis" "advanced stage endometriosis", and "laparoscopic endometriosis", were used. The "related articles" offered by databases were explored to broaden the search, and all abstracts, studies, and citations were reviewed as well. A manual search was also carried out to identify trials for possible inclusion as a supplement. Studies in English language were considered for inclusion. The latest date for this search was on Mar 30 th , 2015. Data extractionTwo of the present authors (Shao-Hui Chen, Zhao-Ai Li) reviewed relevant articles and extracted the specific studies on comparing CL with RAL. If disagreements about inclusion existed, a third reviewer (Xiu-Ping Du) was asked to assess the articles involved until obtaining a consensus. The quality of each study was

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“…The preoperative diagnosis and choice of an appropriate surgical approach are both essential for the treatment of patients with ureteral endometriosis. Regarding surgical treatment for ureteral endometriosis, currently the gold standard is represented by laparoscopy (17), although others (18) suggest the use of robotic surgery in order to improve surgical accuracy and minimize complications. Considering this evidence, the purpose of our study was to identify the best surgical treatments for different types of UE.…”

mentioning

confidence: 99%

Different patterns of pelvic ureteral endometriosis. What is the best treatment? Results of a retrospective analysis

Butticè

Laganà

Mucciardi

et al. 2016

Arch Ital Urol Androl

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Objective. Endometriosis is an estrogendependent disease. The incidence of urinary tract endometriosis (UE) increased during the last few years and, nowadays, it ranges from 0.3 to 12% of all women affected by the disease. The ureter is the second most common site affected. The ureteral endometriosis is classified in extrinsic and intrinsic. The aim of this study is to individuate the best treatments for each subset of ureteral endometriosis. Materials and Methods. 32 patients diagnosed with surgically treated UE were retrospectively reviewed. The patients were divided into 3 subsets (intrinsic UE, extrinsic UE with and without obstruction). The patients with intrinsic UE (n = 10) were treated with laser endoureterotomy. The patients with extrinsic UE (n = 22) were divided in two subsets with (n = 16) and without (n = 6) hydronephrosis. All the patients underwent ureteral stenting, and resection and reimplantation was performed in the first group, and when the mass was > 2.5 cm (n = 3) Boari flap was performed. Laparoscopic ureterolysis (shaving) was performed in the second group. Results. In the extrinsic subset of UE, we obtained an high therapeutic success (84%). Conversely, in the intrinsic subset there was a recurrence rate of the disease in 6/10 of the patients (60%). Conclusions. Ureterolysis seems to be a good treatment in extrinsic UE without obstruction. Resection and reimplantation allows excellent results in the extrinsic UE with obstruction. In the intrinsic subset, the endoureterotomy approach is inadequate.

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The role of the robot in treating urinary tract endometriosis

Abstract: Robotic-assisted laparoscopic techniques have proven useful in the treatment of extensive endometriosis and may prove useful in the treatment of urinary tract endometriosis.

Cited by 12 publications

References 30 publications

Diagnostic and treatment guidelines for gastrointestinal and genitourinary endometriosis

Diagnostic and treatment guidelines for gastrointestinal and genitourinary endometriosis

Robot-assisted versus conventional laparoscopic surgery in the treatment of advanced stage endometriosis: a meta-analysis

Different patterns of pelvic ureteral endometriosis. What is the best treatment? Results of a retrospective analysis

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