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Surgical procedures for treating bladder endometriosis include laparoscopic shaving of serosal lesions and full-thickness resection of deeply infiltrating lesions. Most surgeries are performed laparoscopically, including with robotic assistance. Treatment of ureteral endometriosis (intrinsic and extrinsic) is primarily surgical. Although cases of successful medical management of ureteral endometriosis have been reported, medical treatment does not typically resolve the fibrotic component of the lesion, which is largely responsible for the anatomic distortion and obstruction. The risks of poor medical response include worsened obstruction and decreased renal function. Therefore, in our practice, we treat the ureteral obstruction surgically as soon as the diagnosis is made. The goals of surgical treatment are to remove the endometriotic lesion(s), restore ureteral anatomy, and prevent loss of renal function.

Learning Objectives

At the conclusion of this course, the participant will: 1) Study a presumptive diagnosis of urinary endometriosis according to the symptoms, imaging, and endoscopic studies; 2) Describe the technical aspects of the bladder endometriosis surgical approach; and 3) Treat intrinsic and extrinsic ureteral endometriosis using the indocyanine green fluorescence.

Course Outline

3:15 pm    Welcome, Introduction and Course Overview    
H. Ferreira
3:20 pm    Indocyanine Green Fluorescence to Improve Treatment of Ureteral Endometriosis    
H. Ferreira
3:35 pm    Augmented images for Endometriosis and Adenomyosis Identification Indocyanine Green and Augmented Reality    
N. Bourdel
3:50 pm    Surgical Semeiology of Disease Limits (pre-recorded)    
M. Malzoni
4:05 pm    Questions & Answers - Discussion    
All Faculty
4:15 pm    Adjourn