Ureteral Endometriosis(report of 5 cases)

Objective: To report the diagnosis and treatment of ureteral endometriosis. Methods: 5 cases with ureteral cndometriosis were observed during 1990-2000 and a retrospective analysis is made. Results: Hydroureter and hydronephrosis occured to all 5 cases. 3 cases were diagnosesd correctly preoperative. Ureterolysis of the ureter and excision of the stricture with ureterobladderostomy in 4 and renal function recover in 3 of them and still hydronephrosis in one postoperative. A nephroureterectomy was done in one case with a nonfuctioning kidney and symptoms disappeared postoperative. Conclusions: Most endometriosis cause silent loss of renal function. IVU、RPG and MRU can find hydronephrosis and the site of lesions. Ureteroscopy shiould be considered for intrinsic and mixed forms of ureteral endometriosis to get pathological diagnosis preoperative. Excision of ureter lesion and ureterobladderostomy or ureteroureterostomy should be regularly considered and nephroureterectomy should be performed with nonfunctioning kidney. Additionally, oophorectomy should be done, but hormonal therapy can be altemative for patients who want to preserve fertility.