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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Article info
Publication history
Published online: October 31, 2017
Accepted:
October 30,
2017
Received in revised form:
October 9,
2017
Received:
June 8,
2017
Identification
Copyright
© 2017 Elsevier B.V. All rights reserved.