DİE Cerrahisinde Üreter Komplikasyonları ve Yönetimi
Özet
Endometrial dokunun uterus boşluğunun dışında bulunmasına endometriozis denir. Genel populasyonun%2-10'unda bulunur. Tanısı klinik ve fiziksel muayene,ultrason, manyetik rezonans görüntüleme, çift kontrastlı baryumlu lavman, sistoskopi, bilgisayarlı tomografi ve cerrahi gerekiyorsa lezyonların tanımlanması ve biyopsisine dayanır. Doku biyopsisi ve histolojik doğrulama altın standarttır. Üreter endometriozi yüzeysel endometriozis (YE) ve derin endometriozis olmak üzere iki fenotipe sahiptir. Hidronefroz olmadığında cerrahiyle ilişkili riskleri azaltmak için tıbbi tedavi düşünülebilir. Cerrahi öncesi üreteral kateterler veya stentler kullanılabilir. Ayrıca tedavide sadece infiltran dokunun çıkarılması gibi konservatif üreteroliz planlanabilir. Uçtan uca anastomozlu üreterektomi, üreteroneosistostomi veya nefroüreterektomi gibi radikal yaklaşımları da içerir.
Derin infiltran dokunun yerine ve böbrekteki verdiği hasara göre(fonksiyon kaybı, hidronefroz gibi) tedavi planlanır. Bu hastalar uzmanlaşmış multidisipliner ekipler tarafından yönetilmelidir.
Endometriosis is the presence of endometrial tissue outside the uterine cavity. It is found in 2-10% of the general population. Diagnosis is based on clinical and physical examination, ultrasound, magnetic resonance imaging, double-contrast barium enema, cystoscopy, computed tomography, and if surgery is necessary, identification and biopsy of lesions. Tissue biopsy and histological confirmation are the gold standards. Ureteral endometriosis has two phenotypes: superficial endometriosis (FE) and deep endometriosis. In the absence of hydronephrosis, medical treatment can be considered to reduce the risks associated with surgery. Ureteral catheters or stents can be used before surgery. In addition, conservative ureterolysis, such as removal of only the infiltrating tissue, can be planned for treatment. It also includes radical approaches such as end-to-end anastomosis ureterectomy, ureteroneocystostomy, or nephroureterectomy.
Treatment is planned according to the location of the deep infiltrating tissue and the damage it causes to the kidney (such as loss of function, hydronephrosis). These patients should be managed by specialized multidisciplinary teams.
Referanslar
Angioni S. New insights on endometriosis. Minerva ginecologica. 2017;69(5):438-9.
Eisenberg VH, Weil C, Chodick G, Shalev V. Epidemiology of endometriosis: a large population‐based database study from a healthcare provider with 2 million members. BJOG: An International Journal of Obstetrics & Gynaecology. 2018;125(1):55-62.
Alio L, Angioni S, Arena S, Bartiromo L, Bergamini V, Berlanda N, et al. Endometriosis: seeking optimal management in women approaching menopause. Climacteric. 2019;22(4):329-38.
Vitale SG, La Rosa VL, Rapisarda AMC, Laganà AS. Impact of endometriosis on quality of life and psychological well-being. Journal of Psychosomatic Obstetrics & Gynecology. 2017;38(4):317-9.
Šalamun V, Verdenik I, Laganà AS, Vrtačnik-Bokal E. Should we consider integrated approach for endometriosis-associated infertility as gold standard management? Rationale and results from a large cohort analysis. Archives of gynecology and obstetrics. 2018;297:613-21.
Hosseini SY, Safarinejad MR. Endometriosis of the urinary tract: a report of 3 cases. Urology Journal. 2005;2(1):45-8.
Nisolle M, Donnez J. Peritoneal endometriosis, ovarian endometriosis, and adenomyotic nodules of the rectovaginal septum are three different entities. Fertility and sterility. 1997;68(4):585-96.
Nisolle M, Casanas-Roux F, Anaf V, Mine J-M, Donnez J. Morphometric study of the stromal vascularization in peritoneal endometriosis. Fertility and sterility. 1993;59(3):681-4.
Nisenblat V, Bossuyt PM, Farquhar C, Johnson N, Hull ML. Imaging modalities for the non‐invasive diagnosis of endometriosis. Cochrane Database of Systematic Reviews. 2016(2).
Deiana D, Gessa S, Anardu M, Daniilidis A, Nappi L, D’Alterio MN, et al. Genetics of endometriosis: a comprehensive review. Gynecological Endocrinology. 2019.
Angioni S, D’Alterio MN, Coiana A, Anni F, Gessa S, Deiana D. Genetic characterization of endometriosis patients: review of the literature and a prospective cohort study on a Mediterranean population. International journal of molecular sciences. 2020;21(5):1765.
Laganà AS, Garzon S, Götte M, Viganò P, Franchi M, Ghezzi F, et al. The pathogenesis of endometriosis: molecular and cell biology insights. International journal of molecular sciences. 2019;20(22):5615.
Viganó D, Zara F, Pinto S, Loddo E, Casula L, Soru M, et al. How is small bowel permeability in endometriosis patients? A case control pilot study. Gynecological Endocrinology. 2020;36(11):1010-4.
Tosti C, Pinzauti S, Santulli P, Chapron C, Petraglia F. Pathogenetic mechanisms of deep infiltrating endometriosis. Reproductive Sciences. 2015;22(9):1053-9.
Chapron C, Fauconnier A, Vieira M, Barakat H, Dousset B, Pansini V, et al. Anatomical distribution of deeply infiltrating endometriosis: surgical implications and proposition for a classification. Human reproduction. 2003;18(1):157-61.
Gargett CE, Schwab KE, Brosens JJ, Puttemans P, Benagiano G, Brosens I. Potential role of endometrial stem/progenitor cells in the pathogenesis of early-onset endometriosis. Molecular human reproduction. 2014;20(7):591-8.
Noventa M, Scioscia M, Schincariol M, Cavallin F, Pontrelli G, Virgilio B, et al. Imaging modalities for diagnosis of deep pelvic endometriosis: comparison between trans-vaginal sonography, rectal endoscopy sonography and magnetic resonance imaging. A head-to-head meta-analysis. Diagnostics. 2019;9(4):225.
Berlanda N, Vercellini P, Carmignani L, Aimi G, Amicarelli F, Fedele L. Ureteral and vesical endometriosis: two different clinical entities sharing the same pathogenesis. Obstetrical & gynecological survey. 2009;64(12):830-42.
Donnez J, Nisolle M, Squifflet J. Ureteral endometriosis: a complication of rectovaginal endometriotic (adenomyotic) nodules. Fertility and sterility. 2002;77(1):32-7.
Wu C-J, Huang K-H, Kung F-T. Deep infiltrating endometriosis with obstructive uropathy secondary to ureteral endometriosis. European Journal of Obstetrics and Gynecology and Reproductive Biology. 2012;160(2):239-40.
Umar SA, MacLennan GT, Cheng L. Endometriosis of the ureter. The Journal of urology. 2008;179(6):2412.
Yohannes P. Ureteral endometriosis. The Journal of urology. 2003;170(1):20-5.
Lima GC, Rais-Bahrami S, Link RE, Kavoussi LR. Laparoscopic ureteral reimplantation: a simplified dome advancement technique. Urology. 2005;66(6):1307-9.
MILLER MW, Morgan R. Bilateral ureteric obstruction du to endometriosis resulting in unilateral loss of renal function. British journal of urology (Print). 1990;65(4):421-.
Nezhat C, Nezhat F, Nezhat CH, Nasserbakht F, Rosati M, Seidman DS. Urinary tract endometriosis treated by laparoscopy. Fertility and sterility. 1996;66(6):920-4.
Nezhat CH, Malik S, Nezhat F, Nezhat C. Laparoscopic ureteroneocystostomy and vesicopsoas hitch for infiltrative endometriosis. JSLS: Journal of the Society of Laparoendoscopic Surgeons. 2004;8(1):3.
Seracchioli R, Mabrouk M, Montanari G, Manuzzi L, Concetti S, Venturoli S. Conservative laparoscopic management of urinary tract endometriosis (UTE): surgical outcome and long-term follow-up. Fertility and sterility. 2010;94(3):856-61.
Maggiore ULR, Ferrero S, Candiani M, Somigliana E, Vigano P, Vercellini P. Bladder endometriosis: a systematic review of pathogenesis, diagnosis, treatment, impact on fertility, and risk of malignant transformation. European urology. 2017;71(5):790-807.
Knabben L, Imboden S, Fellmann B, Nirgianakis K, Kuhn A, Mueller MD. Urinary tract endometriosis in patients with deep infiltrating endometriosis: prevalence, symptoms, management, and proposal for a new clinical classification. Fertility and sterility. 2015;103(1):147-52.
Maccagnano C, Pellucchi F, Rocchini L, Ghezzi M, Scattoni V, Montorsi F, et al. Ureteral endometriosis: proposal for a diagnostic and therapeutic algorithm with a review of the literature. Urologia Internationalis. 2013;91(1):1-9.
Leonardi M, Espada M, Kho RM, Magrina JF, Millischer A-E, Savelli L, et al. Endometriosis and the urinary tract: from diagnosis to surgical treatment. Diagnostics. 2020;10(10):771.
Horne AW, Saunders PT. SnapShot: endometriosis. Cell. 2019;179(7):1677-. e1.
Somigliana E, Vercellini P, Gattei U, Chopin N, Chiodo I, Chapron C. Bladder endometriosis: getting closer and closer to the unifying metastatic hypothesis. Fertility and sterility. 2007;87(6):1287-90.
Fedele L, Piazzola E, Raffaelli R, Bianchi S. Bladder endometriosis: deep infiltrating endometriosis or adenomyosis? Fertility and sterility. 1998;69(5):972-5.
Vercellini P, Pisacreta A, Pesole A, Vicentini S, Stellato G, Crosignani PG. Is ureteral endometriosis an asymmetric disease? BJOG: An International Journal of Obstetrics & Gynaecology. 2000;107(4):559-61.
Seracchioli R, Raimondo D, Di Donato N, Leonardi D, Spagnolo E, Paradisi R, et al. Histological evaluation of ureteral involvement in women with deep infiltrating endometriosis: analysis of a large series. Human reproduction. 2015;30(4):833-9.
Guerriero S, Condous G, Van den Bosch T, Valentin L, Leone F, Van Schoubroeck D, et al. Systematic approach to sonographic evaluation of the pelvis in women with suspected endometriosis, including terms, definitions and measurements: a consensus opinion from the International Deep Endometriosis Analysis (IDEA) group. Ultrasound in Obstetrics & Gynecology. 2016;48(3):318-32.
Fernbach S, Maizels M, Conway J. Ultrasound grading of hydronephrosis: introduction to the system used by the Society for Fetal Urology. Pediatric radiology. 1993;23:478-80.
Gantt PA, Hunt JB, McDonough PG. Progestin reversal of ureteral endometriosis. Obstetrics & Gynecology. 1981;57(5):665-7.
Leonardi M, Condous G. Redefining ureterolysis to mirror the skills of modern gynecologists. Journal of Minimally Invasive Gynecology. 2020;27(7):1443-5.
Barra F, Scala C, Biscaldi E, Vellone VG, Ceccaroni M, Terrone C, et al. Ureteral endometriosis: a systematic review of epidemiology, pathogenesis, diagnosis, treatment, risk of malignant transformation and fertility. Human reproduction update. 2018;24(6):710-30.
Ceccaroni M, Ceccarello M, Caleffi G, Clarizia R, Scarperi S, Pastorello M, et al. Total laparoscopic ureteroneocystostomy for ureteral endometriosis: a single-center experience of 160 consecutive patients. Journal of Minimally Invasive Gynecology. 2019;26(1):78-86.
