{"paper_id":"568dc041-5307-4679-9107-0c9398130518","body_text":"JOURNAL TOOLS |\n| Journal policies |\n| Publishing options |\n| eTOC |\n| To subscribe |\n| Submit an article |\n| Recommend to your librarian |\nARTICLE TOOLS |\n| Publication history |\n| Reprints |\n| Permissions |\n| Cite this article as |\n| Share |\nYOUR ACCOUNT\nYOUR ORDERS\nSHOPPING BASKET\nItems: 0\nTotal amount: € 0,00\nHOW TO ORDER\nYOUR SUBSCRIPTIONS\nYOUR ARTICLES\nYOUR EBOOKS\nCOUPON\nACCESSIBILITY\nORIGINAL ARTICLE\nMinerva Obstetrics and Gynecology 2026 Feb 10\nDOI: 10.23736/S2724-606X.25.05847-6\nCopyright © 2025 EDIZIONI MINERVA MEDICA\nlanguage: English\nProphylactic ureteral suturing after ureterolysis in deep endometriosis: description of a conservative laparoscopic technique\nCarlo DE CICCO NARDONE, Maria Cristina SANGIOVANNI ✉, Francesco PLOTTI, Roberto MONTERA, Roberto ANGIOLI, Corrado TERRANOVA\nDepartment of Gynecology and Obstetrics, Campus Bio-Medico University Hospital, Rome, Italy\nBACKGROUND: To describe a novel laparoscopic technique, prophylactic ureteral suturing (PUS), developed to reinforce structurally weakened ureteral segments following extensive ureterolysis for deep endometriosis, to avoid segmental resection or reimplantation.\nMETHODS: In selected patients with deep ureteral endometriosis, circumferential periureteral fibrosis was dissected after cystoscopic insertion of a double-J ureteral stent. Laparoscopic ureterolysis restored ureteral mobility and revealed a mucosa-only segment, considered at high risk of postoperative stricture or rupture, resulting from complete loss of the muscularis layer. The muscularis layers proximal and distal to the mucosal tract were then gently mobilized and reapproximated using interrupted absorbable 3-0 polyglactin sutures, avoiding mucosal penetration. This suture-based reconstruction restored circumferential wall support while maintaining luminal patency.\nRESULTS: An observational study was conducted on a cohort of 6 patients using the novel technique. No intraoperative or postoperative complications were observed. Renal function was preserved in all cases. Among three patients with preoperative hydronephrosis and elevated creatinine, imaging confirmed resolution of obstruction and normalization of renal parameters at follow-up.\nCONCLUSIONS: Prophylactic ureteral suturing may represent a safe and effective conservative alternative to reconstructive procedures in cases of ureteral muscularis loss during ureterolysis. The approach is technically straightforward, preserves ureteral continuity and the native antireflux mechanism, and can be integrated into standard laparoscopic treatment of urinary tract endometriosis. Further studies are warranted to confirm its long-term safety and broader applicability.\nKEY WORDS: Endometriosis; Ureter; Urologic surgical procedures; Laparoscopy; Ureteral diseases; Sutures","source_license":"public-domain-us","license_restricted":false}