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Combined laparoscopic and cystoscopic approach in large deep infiltrating endometriosis of the bladder

Authors :
Horace Roman
G Defortescu
Emanuela Stochino-Loi
J.-C. Millochau
B. Darwish
CHU Rouen
Normandie Université (NU)
Gamétogenèse et Qualité du Gamète - ULR 4308 (GQG)
Université de Rouen Normandie (UNIROUEN)
Normandie Université (NU)-Normandie Université (NU)-Université de Lille
Source :
Journal of Gynecology Obstetrics and Human Reproduction, Journal of Gynecology Obstetrics and Human Reproduction, Elsevier, 2017, 46 (9), pp.691-692. ⟨10.1016/j.jogoh.2017.09.006⟩, Journal of Gynecology Obstetrics and Human Reproduction, 2017, 46 (9), pp.691-692. ⟨10.1016/j.jogoh.2017.09.006⟩
Publication Year :
2017

Abstract

International audience; Resection of endometriosis nodules infiltrating the bladder is routinely performed by laparoscopy. However, laparoscopic resection may lead to inadvertent loss of healthy bladder tissue. Conversely, when bladder nodules are treated by cystoscopy alone, resection may be incomplete. A combined laparoscopic-cystoscopic approach allows safe and controlled resection. The video reports the procedure performed in a 33 year-old primipara who presented with a 40mm bladder nodule. The laparoscopic step is carried out by the gynecologist, who separates the bladder from the uterus and opens the vesico-vaginal space. Concomitantly, the urologist identifies and circumscribes the nodule's limits by cystoscopy. Then, the gynecologist identifies the circular incision previously performed, and completes the resection. The bladder defect is sutured. Early and mid-term postoperative outcomes were uneventful. In patients with large nodules of the bladder, combined laparoscopic-cystoscopic approach allows complete resection of endometriosis lesion, preserves healthy bladder tissue and avoids inadvertent injury of ureters.

Details

ISSN :
24687847
Volume :
46
Issue :
9
Database :
OpenAIRE
Journal :
Journal of gynecology obstetrics and human reproduction
Accession number :
edsair.doi.dedup.....f3a3e97e933842ace2348f41233c9091
Full Text :
https://doi.org/10.1016/j.jogoh.2017.09.006⟩