{"paper_id":"fc7cc930-63fd-4f21-8372-7e83b66c449d","body_text":"Abstract\nPurpose\nAs a serious type of deep infiltrating endometriosis (DIE), ureteral endometriosis (UE) can result in decreased kidney function. The aims of this study are to investigate risk factors and surgical treatments for UE.\nMethods\nThe study enrolled 329 patients with deep infiltrating endometriosis, who were treated with laparoscopic surgery between January 2014 to September 2018. All patients were divided into one of two groups: UE or non-UE. Clinical information and other surgery variables of the two groups were examined.\nResult\nOut of 329 patients with DIE, 68 (20.67%) cases of UE were diagnosed. Among them, 37 patients also had hydroureteronephrosis. In a multivariate analysis, the variables revised American Fertility Society (rAFS) stage IV, uterosacral ligament (USL) DIE lesion ≥ 3 cm in diameter and previous surgery for endometriosis significantly increased the risk of UE. A total of 27.03% (10/37) of patients with UE and hydroureteronephrosis showed decreased kidney function. Ureterolysis was performed in 59 patients, and an ureteroneocystostomy was performed in 9 patients. A double-J stent was placed in 37 patients with UE. Only 1 patient developed acute pyelonephritis postoperatively. During more than 2 years of follow-up, no patient experienced recurrence.\nConclusions\nThe variables of rAFS stage IV, USL DIE lesion ≥ 3 cm in diameter and previous surgery for endometriosis significantly increased the risk of UE. Laparoscopic ureterolysis and ureteroneocystostomy are feasible and safe procedures with low complication and recurrence rates.\nSimilar content being viewed by others\nReferences\nVercellini P, Vigano P, Somigliana E, Fedele L (2014) Endometriosis: pathogenesis and treatment. 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HZ: data collection, data analysis, responsible surgeon, YXS: data collection, responsible surgeon, XXZ: data collection, responsible surgeon, LX: data collection, responsible surgeon, KJL: protocol development, data management, data analysis, manuscript editing, responsible surgeon.\nCorresponding author\nEthics declarations\nConflict of interest\nThe authors declare that they have no conflicts of interest.\nAdditional information\nPublisher's Note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nRights and permissions\nAbout this article\nCite this article\nHu, Z., Li, P., Liu, Q. et al. Ureteral endometriosis in patients with deep infiltrating endometriosis: characteristics and management from a single-center retrospective study. Arch Gynecol Obstet 300, 967–973 (2019). https://doi.org/10.1007/s00404-019-05268-9\nReceived:\nAccepted:\nPublished:\nVersion of record:\nIssue date:\nDOI: https://doi.org/10.1007/s00404-019-05268-9","source_license":"public-domain-us","license_restricted":false}