EURURO Vol. 71 No. 5

800 844

patient interrupted the therapy because of myalgia and
severe arthralgia. Bladder symptoms recurred 3 mo after
treatment discontinuation .
According to the limited evidence available, hormonal
treatments are effective in temporarily suppressing,
but not curing, BE. Hence, if the decision is taken to
medically control the condition and avoid excisional
surgery, long-term treatment should be planned. In these
selected circumstances, estrogen-progestogen combina-
tions and progestogens should be chosen for their
efficacy, safety, and cost-effectiveness that allow pro-
longed periods of therapy, even up to physiologic
menopause Patients should be informed that the
disease may progress under medical treatment, so regular
follow-up is advisable.
3.3.2. Surgical treatment of BE
Surgical treatment of BE nodules should be always
performed after an accurate diagnostic workup; this is
crucial to establish a differential diagnosis with malignant
lesions, to define the exact location of the nodule and its
relationship to the ureteral meatuses, and to clarify the
ureteral status. Two techniques have been proposed for
surgical treatment of BE: TUR surgery and partial cystec-
tomy (alone or in combination). The main objective of each
surgical procedure should be to entirely remove the bladder
lesion. Significant improvements in pain and urinary
symptoms have been observed after excision of the whole
bladder lesion . Complete surgical excision
of nodules also minimizes the risk of recurrence
summarizes the main advantages
Table 5 – Main characteristics and findings of studies investigating surgical treatment of bladder endometriosis
Study Type Setting Patients, n (%) Treatment FU Symptom improvement, Relapse, n (%)
Total BE type, n (mo) n (%)
Antonelli 2006 RS SI 31 14 (45.2) TUR: 2
PC: 9
LPS PC: 3
58 TUR: 0 (0)
PC: 9 (100)
LPS PC: 3 (100)
TUR: 2 (100)
PC: 0 (0)
LPS PC: 0 (0)
Perez-Utrilla 2009 RS SI 12 5 (41.7) TUR: 3
PC: 1
LPS PC: 1
65.6 TUR: NR
PC: NR
LPS PC: NR
TUR: 1 (33.3)
PC: 0 (0)
LPS PC: 0 (0)
Fuentes Pastor 2014 CS SI 2 2 (100) TUR: 2 11.5 TUR: 2 (100) TUR: 0 (0)
Nezhat 1994 RS SI 17 6 (35.3) LPS PC: 6 NR LPS PC: 6 (100) LPS PC: 1 (16.7)
Chapron 1999 RS SI 1650 8 (0.5) LPS PC: 8 31.6 LPS PC: 8 (100) LPS PC: 0 (0)
Seracchioli 2010 PS SI 56 41 (73.2) LPS PC: 41 55 LPS PC: NR LPS PC: 0 (0)
Chapron 2010 PS SI 627 75 (12.0) LPS PC: 75 50.9 LPS PC: 75 (100) LPS PC: 0 (0)
Soriano 2016 RS SI 69 69 (100) LPS PC: 69 36 LPS PC: 67 (97.1) LPS PC: 2/69 (2.9)
Fedele 2005 RS SI 47 47 (100) PC: 29
LPS PC: 18
33.5 PC + LPS PC: 39 (83.0) PC + LPS PC: 5 (10.6)
Chopin 2005 RS SI 132 13 (9.8) LPS PC: 13 39.6 LPS PC: 13 (100) LPS PC: NR
Fleisch 2005 RS SI 23 2 (8.6) PC: 2 45.2 PC: NR PC: NR
Rozsnyai 2011 RS 5I 30 15 (50) LPS PC: 15 24.9 LPS PC: 15 (100) LPS PC: 0 (0)
Kjer 2014 RS SI 30 30 (100) PC: 13
LPS PC: 17
44 PC: 13 (100)
LPS PC: 17 (100)
PC: 0 (0)
LPS PC: 0 (0)
Nezhat 1996 RS SI 28 7 (25) LPS PC: 7 24 LPS PC: 7 (100) LPS PC: 0 (0)
Nezhat 2002 PS SI 15 15 (100) LPS PC: 15 NR NR NR
Seracchioli 2002 CR SI 1 1 (100) LPS PC: 1 NR NR NR
Salvatores 2007 RS SI 21 21 (100) LPS PC: 21 19 LPS PC: 21 (100) NR
Granese 2008 RS 3I 8 8 (100) LPS PC: 8 33.8 LPS PC: 5 (62.5) LPS PC: 0 (0)
Walid 2009 CR SI 1 1 (100) LPS PC: 1 3 LPS PC: 1 (100) NR
Kovoor 2010 RS 2I 169 21 (12.4) LPS PC: 21 20 LPS PC: 18 (85.7) NR
Lusuardi 2012 RS 2I 10 3 (30.0) LPS PC: 3 26.5 LPS PC: 3 (100) LPS PC: 0 (0)
Prager 2012 CR SI 1 1 (100) LPS PC: 1 18 LPS PC: 1 (100) LPS PC: 0 (0)
Nezhat 2014 RS 3I 134 1 (0.7) LPS PC: 1 NR NR NR
Chammas 2008 CR SI 1 1 (100) RA PC: 1 12 RA PC: 1 (100) RA PC: 0 (0)
Liu 2008 CR SI 1 1 (100) RA PC: 1 2 RA PC: 1 (100) RA PC: 0 (0)
Nezhat 2011 CS SI 5 1 (20.0) RA PC: 1 12 RA PC: 1 (100) NR
Collinet 2014 RS 8I 164 23 (14.0) RA PC: 23 9.7 NR RA PC: 0 (0)
Siesto 2014 RS SI 318 5 (1.6) RA PC: 5 28 NR RA PC: 0 (0)
Abo 2016 CS SI 35 3 (8.5) RA PC: 3 12 NR RA PC: 0 (0)
Sener 2006 CR SI 1 1 (100) TUR + LPS PC: 1 3 TUR + LPS PC: 1 (100) NR
Pang 2008 CR SI 1 1 (100) TUR + LPS PC: 1 14 TUR + LPS PC: 1 (100) NR
Xiromeritis 2011 CR SI 1 1 (100) TUR + LPS PC: 1 NR NR NR
Litta 2012 PS SI 12 12 (100) TUR + LPS PC: 12 12 TUR + LPS PC: 11 (91.7) NR
Cheng 2013 CR SI 1 1 (100) TUR + LPS PC: 1 6 TUR + LPS PC: 1 (100) NR
Roman 2014 CR SI 1 1 (100) TUR + LPS PC: 1 NR NR NR
RS = retrospective study; PS = prospective study; CR = case report; CS = case series; SI = single institution; 2I, 3I, 5I, 8I = two, three, five, eight institutions;
FU = mean/median follow-up; LPS PC = laparoscopic partial cystectomy; NR = not reported; RA PC = robot-assisted PC; TUR = transurethral resection.
a The same patient experienced two relapses after two TUR procedures.
b At this follow-up the patient became pregnant.
E U R O P E A N U R O L O G Y 7 1 ( 2 0 1 7 ) 7 9 0 – 8 0 7 800