Different patterns of pelvic ureteral endometriosis. What is the best treatment? Results of a retrospective analysis

Salvatore Butticè, Antonio Simone Laganà, Giuseppe Mucciardi, Francesco Marson, Tzevat Tefik, Christopher Netsch, Salvatore Giovanni Vitale, Emre Sener, Tarık Emre Şener, Rosa Pappalardo, Carlo Magno
Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica · 2016 · vol. 88(4) , pp. 266 · doi:10.4081/aiua.2016.4.266 · PMID:28073190 · W2581724256
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study found that ureterolysis is effective for extrinsic ureteral endometriosis without obstruction, resection and reimplantation for extrinsic endometriosis with obstruction, and endoureterotomy is inadequate for intrinsic ureteral endometriosis.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 ⓘ

This retrospective analysis evaluated different anatomical patterns of pelvic ureteral endometriosis and compared treatment outcomes in patients managed for this condition. The study reported results across distinct ureter-related disease patterns to identify which management approach was associated with better outcomes overall. The primary limitation is the retrospective design, which restricts the ability to infer causality and may be affected by selection and treatment heterogeneity. This paper is centrally about endometriosis—specifically pelvic ureteral endometriosis patterns and treatment outcomes.

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Abstract

OBJECTIVE: Endometriosis is an estrogendependent disease. The incidence of urinary tract endometriosis (UE) increased during the last few years and, nowadays, it ranges from 0.3 to 12% of all women affected by the disease. The ureter is the second most common site affected. The ureteral endometriosis is classified in extrinsic and intrinsic. The aim of this study is to individuate the best treatments for each subset of ureteral endometriosis. MATERIALS AND METHODS: 32 patients diagnosed with surgically treated UE were retrospectively reviewed. The patients were divided into 3 subsets (intrinsic UE, extrinsic UE with and without obstruction). The patients with intrinsic UE (n = 10) were treated with laser endoureterotomy. The patients with extrinsic UE (n = 22) were divided in two subsets with (n = 16) and without (n = 6) hydronephrosis. All the patients underwent ureteral stenting, and resection and reimplantation was performed in the first group, and when the mass was > 2.5 cm (n = 3) Boari flap was performed. Laparoscopic ureterolysis (shaving) was performed in the second group. RESULTS: In the extrinsic subset of UE, we obtained an high therapeutic success (84%). Conversely, in the intrinsic subset there was a recurrence rate of the disease in 6/10 of the patients (60%). CONCLUSIONS: Ureterolysis seems to be a good treatment in extrinsic UE without obstruction. Resection and reimplantation allows excellent results in the extrinsic UE with obstruction. In the intrinsic subset, the endoureterotomy approach is inadequate.

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Condition tags

mesh:D004715endometriosis

MeSH descriptors

Endometriosis Ureteral Diseases Adult Endometriosis Endometriosis Female Humans Middle Aged Retrospective Studies Ureteral Diseases Ureteral Diseases Urologic Surgical Procedures

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