To describe the surgical management and the risks of postoperative complications of patients suffering from urinary tract endometriosis (UTE) in France in 2017.
Multicentric retrospective cohort pilot study.
Department of Gynecology in 31 expert endometriosis centers.
All women managed surgically for UTE, from January 1 to December 31 2017. We distinguished patient with isolated bladder endometriosis (IBE) or isolated ureteral endometriosis (IUE) and patients associating both locations (mixed locations, ML).
Surgeons belonging to the FRIENDS group enrolled patients by filling a 24 items questionnaire on the day of the inclusion and three month later. Data were collected on operative routes, surgical management and postoperative complications according to the Clavien-Dindo classification, in a single anonymized database.
A total of 232 patients from 31 centers were included. IBE was found in 82 patients (35.3%), IUE in 126 patients (54.4%) ML in 24 patients (10.3%). Surgery was performed by laparoscopy, laparotomy or robot-assisted laparoscopy in 74.1%, 11.2% and 14.7% of cases respectively. Among the 150 ureteral lesions (IUE and ML), 114 were managed with ureterolysis (76%), 28 with ureteral resections (18.7%), 4 with nephrectomies (2.7%) and 23 with cystectomies (15.3%). Concerning bladder endometriosis, a partial cystectomy was performed in 94.3% of cases. We reported 61 postoperative complications (26.3%), 44 low grade complications according to the Clavien-Dindo classification (18%), 16 grade III complications (7%) and one grade IV complication (peritonitis).
The surgical management of ureteral and bladder endometriosis is usually feasible and safe through laparoscopic surgery. Ureteral resection, when necessary, is more strongly associated with laparotomy and with more complications compared to other procedures. Prospective controlled studies are still mandatory to assess the best surgical management for the patients.

Copyright © 2021. Published by Elsevier Inc.