Management of ureteral endometriosis: areas of controversy

Fabio Ghezzi, Cromi A, Antonella Cromi, Valentino Bergamini, Bergamini V, Pierfrancesco Bolis, Bolis P
Current opinion in obstetrics & gynecology · 2007 · vol. 19(4) , pp. 319–324 · doi:10.1097/gco.0b013e328216f803 · PMID:17625412 · W2044138585
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This review critically evaluates current knowledge and controversies regarding the pathogenesis, diagnosis, and treatment of ureteral endometriosis, noting diagnostic limitations and surgical management debates.

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Abstract

PURPOSE OF REVIEW: In this review we critically evaluate what we know and what we still do not know about pathogenesis, diagnosis and treatment of ureteral endometriosis, highlighting areas of controversy. RECENT FINDINGS: Recent studies have produced new insights into diagnostic and management options for ureteral endometriosis. SUMMARY: The diagnosis of ureteral endometriosis entails a high index of suspicion for the disorder. Imaging techniques are of limited value in providing an accurate depiction of extension of ureteral lesions. Preliminary results suggest that magnetic resonance urography is accurate in differentiating between intrinsic and extrinsic forms of ureteral involvement, but further studies are required to define its role in directing better treatment. Current controversies in the treatment of ureteral endometriosis are over whether segmental resection and anastomosis or ureterolysis are indicated, and whether minimal-access procedures are equally effective than their traditional open counterparts. Recent studies suggest that laparoscopic ureterolysis can be an effective treatment option in most patients with ureteral endometriosis but that recurrence rates are not negligible, as suggested in pioneering works. Successful application of laparoscopic surgery, even for procedures that have traditionally necessitated laparotomy, has been reported. Extensive experience with endourological techniques is prerequisite for success.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Endometriosis Laparoscopy Ureter Ureteral Diseases Ureteral Diseases Endometriosis Endometriosis Female Humans Laparoscopy Prevalence Recurrence Treatment Outcome Ureter Ureteral Diseases Ureteral Diseases Urography

Citation neighborhood

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. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (67)

Cited by (38)

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License: CC0 · commercial use OK