Outcome of laparoscopic ureterolysis for ureteral endometriosis

Fabio Ghezzi, Cromi A, Antonella Cromi, Valentino Bergamini, Bergamini V, Maurizio Serati, Sacco A, Alessandro Sacco, Michael D. Mueller
Fertility and sterility · 2006 · vol. 86(2) , pp. 418–22 · doi:10.1016/j.fertnstert.2005.12.071 · PMID:16764874
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Laparoscopic ureterolysis was effective in treating moderate-to-severe hydronephrosis from ureteral endometriosis in 96.7% of patients at 3 months, with a 12.1% recurrence rate over a median 16-month follow-up.

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Abstract

OBJECTIVE: To evaluate the adequacy of laparoscopic ureterolysis as a primary treatment option for ureteral endometriosis. DESIGN: Prospective collaborative cohort study. SETTING: Gynecologic departments of three university hospitals. PATIENT(S): Women with ureteral endometriosis exhibiting moderate-to-severe hydronephrosis on preoperative intravenous pyelography. INTERVENTION(S): Laparoscopic ureterolysis. MAIN OUTCOME MEASURE(S): Cure rate, disesase recurrence. RESULT(S): Thirty-three patients underwent laparoscopic ureterolysis during the study period. Bilateral involvement of ureters was found in 4 (12.1%) cases. In women with unilateral lesions the left ureter was more frequently affected (24/29 vs. 5/29). Ureteral involvement was associated with uterosacral ligaments endometriosis in 65.5% (22/34) of cases. No inadvertent ureteral injuries occurred during ureterolysis. A partial wall resection of the ureter was necessary in one case and a segmental ureteral resection with vescicopsoas hitch was required in a women with intrinsic ureteral endometriosis. The median (range) follow-up time was 16 months (range: 3-53 months). Thirty-two patients (96.7%) had a patent ureter on the 3-month postoperative intravenous pyelography. The recurrence rate of ureteral lesions was 12.1% (4/33). CONCLUSION(S): Our findings suggest that a conservative laparoscopic approach is an effective treatment option in most patients with ureteral endometriosis exhibiting moderate-to-severe hydronephrosis.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Laparoscopy Laparoscopy Ureter Ureteral Diseases Adult Adult Cohort Studies Cohort Studies Endometriosis Endometriosis Endometriosis Endometriosis Female Female Follow-Up Studies Follow-Up Studies Humans Humans Hydronephrosis

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

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