Abstract
We aim to describe the diagnosis and surgical management of urinary tract endometriosis (UTE). We detail current diagnostic tools, including advanced transvaginal ultrasound, magnetic resonance imaging, and surgical diagnostic tools such as cystourethroscopy. While discussing surgical treatment options, we emphasize the importance of an interdisciplinary team for complex cases that involve the urinary tract. While bladder deep endometriosis (DE) is more straightforward in its surgical treatment, ureteral DE requires a high level of surgical skill. Specialists should be aware of the important entity of UTE, due to the serious health implications for women. When UTE exists, it is important to work within an interdisciplinary radiological and surgical team.
Highlights
Endometriosis is a chronic and benign condition thought to affect up to 10% of female-born individuals [1]
When there is proven hematuria or a bladder nodule visible on transvaginal ultrasound (TVS) or Magnetic resonance imaging (MRI), we find that performing a cystourethroscopy may be helpful to confirm the diagnosis
Women who respond to medical management can continue the treatment until menopause or until the desire to conceive from pregnancy or to achieve an optimal quality of life and reduce the risk of progression, unless there is superimposed hydronephrosis, in which instance surgery would be the first treatment choice to prevent irreversible renal failure from ureteral obstruction
Summary
Endometriosis is a chronic and benign condition thought to affect up to 10% of female-born individuals [1]. It causes cyclic pelvic pain and infertility. Other symptoms can include noncyclical pelvic pain, bloating, change in bowel habits, urinary tract symptoms, and fatigue. It was historically considered a gynecologic condition, managed by obstetrician-gynecologists. It is increasingly recognized that endometriosis is a multiorgan and systemic inflammatory disease that necessitates interdisciplinary care, led by a gynecologist with subspecialty training in clinical and surgical management [2,3]. The term urinary tract endometriosis (UTE) refers to endometriotic implants of the bladder, ureter, kidney, and urethra. Diagnostics 2020, 10, 771 review the epidemiology, pathogenesis, clinical presentation, diagnosis and differential diagnosis, with emphasis on the imaging and management of UTE
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