DOI QR코드

DOI QR Code

Sequential treatment with transurethral resection and hormonal therapy for bladder endometriosis of vesicoureteric junction

  • Abdulelah AlAdimi (Departments of Urology, Alemadi Hospital) ;
  • Nabil AlOdaini (Departments of Urology, Alemadi Hospital) ;
  • Atef M. M. Darwish (Department of Obstetrics and Gynecology, Alemadi Hospital)
  • 투고 : 2022.06.09
  • 심사 : 2022.08.24
  • 발행 : 2022.12.31

초록

Objective: To estimate the efficacy of sequential treatment of bladder endometriosis (BE) of the vesicoureteric junction using transurethral resection (TUR) and hormonal therapy. Design: Case report. Setting: Private multispecialty hospital. Patient: A multiparous woman presented with perimenstrual lower urinary tract symptoms, cyclic chronic pelvic pain, and left loin pain. Intervention[s]: Ultrasonography revealed marked left renal dilatation. Computed tomography confirmed the presence of a bladder mass. A diagnostic cystoscopy revealed compression of the left vesicoureteral junction. Complete TUR BE with release of chocolate material during resection, followed by ureteric double J stent insertion for 3 months, was performed. Histopathology confirmed the diagnosis of BE, followed by adjuvant hormonal therapy (dienogest) for 3 months. Follow-up for about 2 years revealed complete relief of the symptoms without any recurrence. Main Outcome Measure[s]. Success and recurrence rates of sequential TUR and hormonal therapy of BE of the vesicoureteric junction. Result[s]. TUR BE followed by adjuvant hormonal therapy was very effective in eradicating BE of the vesicoureteric junction in a safe manner without recurrence on follow-up for 2 years. Conclusion[s]. BE of the vesicoureteric junction can be properly treated by sequential TUR and hormonal therapy without recurrence over a 2-year follow-up.

키워드

참고문헌

  1. Leonardi M, Espada M, Kho RM, Magrina JF, Millischer AE, Savelli L, et al. Endometriosis and the urinary tract: from diagnosis to surgical treatment. Diagnostics (Basel) 2020;10:771.
  2. Leone Roberti Maggiore U, Ferrero S, Candiani M, Somigliana E, Vigano P, Vercellini P. Bladder endometriosis: a systematic review of pathogenesis, diagnosis, treatment, impact on fertility, and risk of malignant transformation. Eur Urol 2017;71:790-807.
  3. Shah P, Shah P, Patel PB, Parmar JS, Shah F. Bladder endometriosis: management by cystoscopic and laparoscopic approaches. J Minim Invasive Gynecol 2019;26:807-8.
  4. Charatsi D, Koukoura O, Ntavela IG, Chintziou F, Gkorila G, Tsagkoulis M, et al. Gastrointestinal and urinary tract endometriosis: a review on the commonest locations of extrapelvic endometriosis. Adv Med 2018;2018:3461209.
  5. Pliszkiewicz M, Pliszkiewicz M, Brzuchalski MA, Siekierski BP. Bladder endometriosis - long-term efficacy of radical laparoscopic surgery. Pol Merkur Lekarski 2019;47:139-43.
  6. Leonardi M, Martins WP, Espada M, Georgousopoulou E, Condous G. Prevalence of negative sliding sign representing pouch of Douglas obliteration during pelvic transvaginal ultrasound for any indication. Ultrasound Obstet Gynecol 2020;56:928-33.
  7. Rousset P, Bischoff E, Charlot M, Grangeon F, Dubernard G, Paparel P, et al. Bladder endometriosis: preoperative MRI analysis with assessment of extension to ureteral orifices. Diagn Interv Imaging 2021;102:255-63.
  8. Mor Y, Leibovitch I, Zalts R, Lotan D, Jonas P, Ramon J. Analysis of the long-term outcome of surgically corrected vesico-ureteric reflux. BJU Int 2003;92:97-100.
  9. Angioni S, Nappi L, Pontis A, Sedda F, Luisi S, Mais V, et al. Dienogest. A possible conservative approach in bladder endometriosis. Results of a pilot study. Gynecol Endocrinol 2015;31:406-8.
  10. Murji A, Biberoglu K, Leng J, Mueller MD, Romer T, Vignali M, et al. Use of dienogest in endometriosis: a narrative literature review and expert commentary. Curr Med Res Opin 2020;36:895-907.
  11. Strowitzki T, Faustmann T, Gerlinger C, Schumacher U, Ahlers C, Seitz C. Safety and tolerability of dienogest in endometriosis: pooled analysis from the European clinical study program. Int J Womens Health 2015;7:393-401.
  12. Kanto A, Kotani Y, Murakami K, Miyagawa C, Nakai H, Matsumura N. A case report of bladder and intestinal endometriosis, and the relationship between sex hormone receptor expression and PIK3CA mutation analysis. BMC Womens Health 2021;21:118.
  13. Schindler AE. Dienogest in long-term treatment of endometriosis. Int J Womens Health 2011;3:175-84.
  14. Cordeiro Gonzalez P, Punal Pereira A, Blanco Gomez B, Lema Grille J. Bladder endometriosis: report of 7 new cases and review of the literature. Arch Esp Urol 2014;67:646-9.
  15. Strowitzki T, Marr J, Gerlinger C, Faustmann T, Seitz C. Dienogest is as effective as leuprolide acetate in treating the painful symptoms of endometriosis: a 24-week, randomized, multicentre, open-label trial. Hum Reprod 2010;25:633-41.
  16. Wild M, Miskry T, Al-Kufaishi A, Rose G, Crofton M. Medical management of deeply infiltrating endometriosis - 7 year experience in a tertiary endometriosis centre in London. Gynecol Surg 2019;16:12.
  17. Selcuk I, Bozdag G. Recurrence of endometriosis; risk factors, mechanisms and biomarkers; review of the literature. J Turk Ger Gynecol Assoc 2013;14:98-103.
  18. Hansen UD, Gradel KO, Larsen MD. Danish urogynaecological database. Clin Epidemiol 2016;8:709-12.