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Aim: To determine the outcomes of laparoscopic partial cystectomy (LPC) for bladder endometriosis (BE). Methods: This was a retrospective study using medical records of women who underwent LPC for BE between January 2009 and December 2017. Demographic characteristics, surgical findings, including surgical site and size of the bladder lesion, endometriosis at other locations, and pre- and postoperative hormonal treatment data were collected. Results: We analyzed data of 18 women with full-thickness BE. The patients had a mean age of 34 (range, 26-45) years and body mass index of 21.6 (range, 16.1-25) kg/m2. All women had dysmenorrhea. Other symptoms noted include dysuria, gross hematuria, and infertility. BE with a mean diameter of 2.7 cm (range, 1-5) was most commonly found at the posterior wall of the bladder (94.4%). Peritoneal endometriosis (94.4%), endometrioma (33.3%), and deep endometriotic nodules (22.2%) in the posterior compartment were also found. No surgical complications were observed. Postoperative hormonal treatment was administered to 14 (77.8%) patients. All symptoms improved after the surgery. No recurrence was found after 30 (range, 12-74) months of follow-up. Conclusion: LPC is an effective treatment option for BE.
RESUMO
Objective: Sperm donation and hormonal therapy with micro-Testicular Epididymal Sperm Extraction (TESE) for infertility from testicular failure might not always be available in some contexts. We report a successful embryo transfer from the patient-by 'cumulative sperm collection' strategy. Case report : A 42 year-old male presented with non-obstructive azoospermia from testicular failure. Hormonal treatments were given along with the patient-initiated 'cumulative sperm collection' strategy, which eventually resulted in 17 sperms retrieved. Twelve mature oocytes were selected for intracytoplasmic sperm injection (ICSI) with the retrieved sperms, of which 8 oocytes were successfully fertilized but only two reached the early blastocyst stage; the first embryo transfer was not successful. Another five eggs were thawed and fertilized with the remaining 5 sperms and 3 oocytes were successfully fertilized: Seven cells were grade 3, 6 cells were grade 3, and 3 cells were grade 3. The second embryo transfer was successful, and the term female infant was successfully delivered by cesarean section. Conclusion: At a center without micro-TESE availability, successful embryo transfer for testicular failure type IV could be achieved by hormonal therapy plus a 'cumulative sperm collection' strategy.
RESUMO
The authors reported the first case of endometriosis with ureteral involvement causing nonfunctioning kidney, which was managed by laparoscopic nephrectomy, hysterectomy, and endometriotic mass removal in a single session.