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Full length article| Volume 220, P12-17, January 2018

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Fertility outcomes after laparoscopic partial bladder resection for deep endometriosis: Retrospective analysis from two expert centres and review of the literature

  • Krystel Nyangoh Timoh
    Correspondence
    Corresponding author at: Service de Gynécologie-Obstétrique. Hôpital Tenon, AP-HP, Paris, France.
    Affiliations
    Department of Obstetrics and Gynecology, Tenon Hospital, AP-HP, Paris, University Pierre et Marie Curie, Paris 6, France
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  • Marcos Ballester
    Affiliations
    Department of Obstetrics and Gynecology, Tenon Hospital, AP-HP, Paris, University Pierre et Marie Curie, Paris 6, France

    GRC6-UPMC, Centre expert en Endométriose (C3E), France

    UMR_S938 University Pierre et Marie Curie Paris, France
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  • Sofiane Bendifallah
    Affiliations
    Department of Obstetrics and Gynecology, Tenon Hospital, AP-HP, Paris, University Pierre et Marie Curie, Paris 6, France

    GRC6-UPMC, Centre expert en Endométriose (C3E), France
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  • Arnaud Fauconnier
    Affiliations
    Department of Obstetrics and Gynecology, Poissy Hospital, University of Saint Quentin en Yvelines, Paris, Saclay, France
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  • Emile Darai
    Affiliations
    Department of Obstetrics and Gynecology, Tenon Hospital, AP-HP, Paris, University Pierre et Marie Curie, Paris 6, France

    GRC6-UPMC, Centre expert en Endométriose (C3E), France

    UMR_S938 University Pierre et Marie Curie Paris, France
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Published:October 31, 2017DOI:https://doi.org/10.1016/j.ejogrb.2017.10.031

      Abstract

      Objective

      To evaluate fertility outcomes after laparoscopic partial bladder resection in women with bladder endometriosis and to review the literature.

      Study design

      A retrospective study conducted at two tertiary referral centres –Tenon University Hospital and Poissy University Hospital (Canadian Task Force Classification Level II-2)–from July 2006 to November 2015.
      Patients with bladder endometriosis who underwent either laparoscopic partial bladder resection (PBR) alone for those without posterior endometriotic lesions (PBR group) or both laparoscopic PBR and associated posterior deep infiltrating endometriosis (DIE) resection (PBR-PDIE group) were included. Pregnancy and live birth rates according to prior infertility, and associated posterior DIE resection were analysed.

      Results

      Thirty-four patients were included; 15 in the PBR group and 19 in the PBR-PDIE group. The median age (range) was 31 years (25–37), Seventeen patients (50%) had prior infertility. The median follow-up after bladder resection was 60.6 months (12–116). Overall, of the 25 (73.5%) patients who wished to conceive, 17 (68%) achieved pregnancies resulting in a live birth rate of 76.4%. Among the 17 patients with prior infertility, nine (52.9%) conceived. Overall, eight patients (53.3%) in the PBR group conceived and nine (47.3%) in the PBR-PDIE group (difference not significant).

      Conclusion

      The present study demonstrates that laparoscopic PBR results in a high pregnancy rate in patients with prior infertility as well as in those with associated posterior DIE suggesting that surgery could be an acceptable alternative to first-line assisted reproductive technology.

      Keywords

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