Robotic Assisted En-Bloc Removal of Kidney, Ureter and Bladder Wall for Endometriosis.
J Minim Invasive Gynecol
; 31(5): 368, 2024 May.
Article
em En
| MEDLINE
| ID: mdl-38360392
ABSTRACT
STUDY OBJECTIVE:
To highlight a case where a nephroureterectomy and partial bladder cystectomy needed to be done due to endometriosis.DESIGN:
A video article demonstrating a case study and the surgical management.SETTING:
Ureteral endometriosis is a complex form of endometriosis [1]. If left untreated, the ureter can become significantly compressed leading to hydroureter, hydronephrosis and complete loss of kidney function [2].INTERVENTIONS:
This is a case of a 29-year-old patient with pelvic pain and cyclical rectal bleeding. Further investigation showed significant left hydronephrosis and almost complete loss of left kidney function (8% on renogram). MRI revealed endometriosis involving the posterior bladder wall and distal left ureter, a large full-thickness sigmoid nodule and a large left endometrioma. The patient underwent a robotic-assisted left nephroureterectomy, partial cystectomy (bladder), excision of pelvic endometriosis and sigmoid resection. This procedure was performed jointly with the gynecologist, urologist, and colorectal surgeon and the SOSURE technique was employed [3]. The specimen (left kidney, whole length of ureter and bladder wall around ureteric orifice) was removed en-bloc through a small 3cm extension of the umbilical incision. As the distance between the sigmoid nodule and the anal verge was 35cm, which was above the limit of the transanal circular stapler, a limited resection was performed over a discoid excision. The patient made a good recovery postoperatively.CONCLUSION:
Ureteral endometriosis is an indolent and aggressive condition which can lead to silent kidney loss. It is essential that hydronephrosis and hydroureter is ruled out in cases with deep endometriosis. Isolated hydronephrosis should also prompt a suspicion for endometriosis.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doenças Ureterais
/
Endometriose
/
Procedimentos Cirúrgicos Robóticos
Limite:
Adult
/
Female
/
Humans
Idioma:
En
Revista:
J Minim Invasive Gynecol
/
J. minim. invasive gynecol
/
Journal of minimally invasive gynecology
Assunto da revista:
GINECOLOGIA
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Reino Unido