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    10 1016@j Jmig 2019 10 024

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    The document describes a step-by-step laparoscopic surgery to treat bladder and left ureter endometriosis in a 27-year old patient. The surgery involved partial cystectomy to remove a bladder nodule, ureterolysis to dissect an endometriosis nodule compressing the ureter, ureteral resection of a stenotic segment, and an end-to-end ureteral anastomosis. The postoperative course was uneventful and the technique was described as simple with low morbidity.

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    10 1016@j Jmig 2019 10 024

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    The document describes a step-by-step laparoscopic surgery to treat bladder and left ureter endometriosis in a 27-year old patient. The surgery involved partial cystectomy to remove a bladder nodule, ureterolysis to dissect an endometriosis nodule compressing the ureter, ureteral resection of a stenotic segment, and an end-to-end ureteral anastomosis. The postoperative course was uneventful and the technique was described as simple with low morbidity.

    Original Description:

    Urinary Endometriosis

    Original Title

    10.1016@j.jmig.2019.10.024

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    The document describes a step-by-step laparoscopic surgery to treat bladder and left ureter endometriosis in a 27-year old patient. The surgery involved partial cystectomy to remove a bladder nodule, ureterolysis to dissect an endometriosis nodule compressing the ureter, ureteral resection of a stenotic segment, and an end-to-end ureteral anastomosis. The postoperative course was uneventful and the technique was described as simple with low morbidity.

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    © All Rights Reserved
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    Download as pdf or txt
    34 views3 pages

    10 1016@j Jmig 2019 10 024

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    houssein.hajj.md
    The document describes a step-by-step laparoscopic surgery to treat bladder and left ureter endometriosis in a 27-year old patient. The surgery involved partial cystectomy to remove a bladder nodule, ureterolysis to dissect an endometriosis nodule compressing the ureter, ureteral resection of a stenotic segment, and an end-to-end ureteral anastomosis. The postoperative course was uneventful and the technique was described as simple with low morbidity.

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    Journal Pre-proof

    Bladder and urinary deep pelvic endometriosis: a step-by-step


    standard approach

    Marie PATÉ MD , Anne-Sophie HAUSS MD , Emilie FALLER MD ,


    Jules COLIN MD , Lise LECOINTRE MD ,
    Cherif AKLADIOS MD-PHD

    PII: S1553-4650(19)31294-4
    DOI: https://doi.org/10.1016/j.jmig.2019.10.024
    Reference: JMIG 4004

    To appear in: The Journal of Minimally Invasive Gynecology

    Received date: 1 August 2019


    Revised date: 19 October 2019
    Accepted date: 29 October 2019

    Please cite this article as: Marie PATÉ MD , Anne-Sophie HAUSS MD , Emilie FALLER MD ,
    Jules COLIN MD , Lise LECOINTRE MD , Cherif AKLADIOS MD-PHD , Bladder and urinary deep
    pelvic endometriosis: a step-by-step standard approach, The Journal of Minimally Invasive Gynecol-
    ogy (2019), doi: https://doi.org/10.1016/j.jmig.2019.10.024

    This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition
    of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of
    record. This version will undergo additional copyediting, typesetting and review before it is published
    in its final form, but we are providing this version to give early visibility of the article. Please note that,
    during the production process, errors may be discovered which could affect the content, and all legal
    disclaimers that apply to the journal pertain.

    © 2019 Published by Elsevier Inc. on behalf of AAGL.


    Title : Bladder and urinary deep pelvic endometriosis : a step-
    by-step standard approach
    Authors :
    1- Marie PATÉ1, MD
    2- Anne-Sophie HAUSS1, MD
    3- Emilie FALLER1, MD
    4- Jules COLIN2, MD
    5- Lise LECOINTRE1, MD
    6- Cherif AKLADIOS1, MD-PHD

    Adresses :
    1
    Department of Gynecology, Pôle de gynécologie-obstétrique, Strasbourg University
    Hospital, 1 avenue Molière, 67200 Strasbourg, France
    2
    Departement of Emergency, Pole urgence-reanimation-SAMU-SMUR, Strasbourg University
    Hospital, 1 avenue Molière, 67200 Strasbourg, France

    E-mail of the author :


    marie.pate@9online.fr
    phone number : +33 6 68 07 98 12

    Authors report having no conflict of interest

    Abstract
    Objective: To demonstrate how to treat bladder and ureteral deep pelvic endometriosis using a
    laparoscopic approach with partial cystectomy and resection and end-to-end anastomosis of the ureter.
    Design: A step-by-step explanation of the surgery using video, approved by the local Institutional
    Review Board
    Setting: University Hospital of Strasbourg, France. A 27-year-old nulliparous woman with severe
    endometriosis stage 4 (AFS-R score >40) of the bladder and left ureter. On pelvic MRI, we found left
    uretero-hydronephrosis induced by a 17mm endometriosis nodule. A JJ probe was placed on the left
    ureter before the surgery because of the dilatation of the ureter and the decreased of renal function.
    Interventions: During the exploration, we found an abdominal cavity free of adhesion. There
    was an endometriosis implant in the bladder in front of the uterus and a large nodule of the
    left uterosacral ligament that was compressing the ureter. In the first step, we made a section
    of the round ligament, to perform anterior ureterolysis and progressive dissection of the
    nodule surrounding the ureter. Once the nodule was resected, a tight stenosis was observed
    at about 1 cm from the bladder. The vesico-uterine and the vesico-vaginal spaces were then
    dissected to pass under the nodule to the vagina. We opened the dome of the bladder with
    the thunderbeatTM (Olympus) and dissected the bladder to remove the transfixing nodule
    while staying away from the ureters. The closure of the bladder was performed by 2 lateral
    sutures and by a running suture of braided suture (V-LocTM) 2-0 with a good tightness
    checked by a blue test. Ureteral resection was performed around the JJ probe in place to
    remove the stenotic zone, then we performed a end-to-end anastomosis of the ureter by 4
    sutures of monofilament (MonocrylTM) 4 -0 with a good anatomical result. Finally an
    omentoplasty was fixed around the ureter by 2-0 monofilament suture (MonocrylTM). Post
    operative course was uneventful. Foley catheter was let in place 10 days and JJ probe was
    removed 6 weeks later. Operative time was 140 minutes. The step-by-step explanation
    technique was simple with minimal operative difficulty and low rate of morbidity.

    Conclusion: This video shows how deep urinary endometriosis can be performed
    laparoscopically. Mastering suturing is essential to avoid complications.

    Keywords: Laparoscopy; deep pelvic endometriosis ; Bladder endometriosis; resection-anastomosis


    of the ureter

    Video Legend
    Video of a step-by-step surgery of urinary tract endometriosis by laparoscopy with partial
    cystectomy and resection with end-to-end anastomosis of the ureter.


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