Efficacy of Laparoscopic Partial Cystectomy with a Transurethral Resectoscope in Patients with Bladder Endometriosis: See-Through Technique.


Journal

Urologia internationalis
ISSN: 1423-0399
Titre abrégé: Urol Int
Pays: Switzerland
ID NLM: 0417373

Informations de publication

Date de publication:
2020
Historique:
received: 03 06 2019
accepted: 30 09 2019
pubmed: 20 3 2020
medline: 23 4 2021
entrez: 20 3 2020
Statut: ppublish

Résumé

Bladder endometriosis (BE) is rare. Deep invasive endometriosis is difficult to control with medications alone; such cases need surgical treatment. Good results of laparoscopic partial cystectomy with a transurethral (TU) resectoscope by the see-through technique for patients with BE are reported. From January 2008 to February 2016, 12 cases of symptomatic BE were seen in our institution. The chief complaints of 9 cases were micturition pain during menstruation. Preoperative cystoscopy showed a bladder mass with blueberry spots. All surgeries were performed under general anesthesia. Laparoscopic surgery was performed with a fan of 4 ports in the lower abdomen. First, the uterus and bilateral ovaries were checked. Then, the TU resectoscope was inserted. When the affected bladder wall was identified, it was again observed with the laparoscopic light source off, which made it possible to observe the twilight leaking inside from the bladder. This twilight came from the light source of the TU resectoscope via the unaffected bladder wall. In contrast, the thickness of the affected wall prevented the light from inside the bladder from passing through it. We call this the "see-through technique." The tumor was then safely dissected with both laparoscopic and TU resection procedures. Finally, the bladder was sutured by laparoscopic procedures using absorbable sterile surgical suture. The urethral catheter was removed after cystography 7 days after the operation. The surgical margins of all cases were negative. There has been no recurrence of BE so far in any patients. There were no major adverse events perioperatively and the urinary symptoms improved in all cases. By laparoscopic partial cystectomy assisted with a TU resectoscope and see-through technique, the edge of BE could be easily and precisely identified. These procedures are effective and safe for BE surgical treatment.

Identifiants

pubmed: 32191941
pii: 000503795
doi: 10.1159/000503795
pmc: PMC7592933
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

546-550

Informations de copyright

© 2020 The Author(s) Published by S. Karger AG, Basel.

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Auteurs

Yuki Endo (Y)

Department of Urology, Nippon Medical School, Tokyo, Japan.

Jun Akatsuka (J)

Department of Urology, Nippon Medical School, Tokyo, Japan.

Kotaro Obayashi (K)

Department of Urology, Nippon Medical School, Tokyo, Japan.

Hayato Takeda (H)

Department of Urology, Nippon Medical School, Tokyo, Japan.

Tatsuro Hayashi (T)

Department of Urology, Nippon Medical School, Tokyo, Japan.

Satoko Nakayama (S)

Department of Urology, Nippon Medical School, Tokyo, Japan.

Yasutomo Suzuki (Y)

Department of Urology, Nippon Medical School, Tokyo, Japan.

Tsutomu Hamasaki (T)

Department of Urology, Nippon Medical School, Tokyo, Japan.

Yukihiro Kondo (Y)

Department of Urology, Nippon Medical School, Tokyo, Japan, kondoy@nms.ac.jp.

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Classifications MeSH