Clinical analysis of ureteral endometriosis

Objective To explore the clinical features,diagnosis and treatment of ureteral endometriosis.Methods The clinical data in 15 patients with ureteral endometriosis were analyzed retrospectively.Results All patients in this group were manifested by the main symptoms of lower abdominal pain or lumbar discomfort during premenstrual and menstrual periods.7 cases suffered from adenomyosis and other 8 cases from ovarian endometriosis or pelvic endometriosis.Preoperative B-ultrasound in 10 cases indicated mild to severe upper urinary tract dilation and hydrops,pelvis was separated by 12-50 mm.Preoperative intravenous urography(IVU) showed upper urinary tract dilation and hydrops in 7 cases and unclear developing in 3 cases.Preoperative urinary B-ultrasound in 5 cases found no ureteral dilation,but found nodular proliferation in middle and lower segment of urethra during intraoperative period.All the cases were treated surgically,5 cases were performed ureteral lesion resection and ureterolysis,9 cases were treated with ureterostenosis segment resection and ureteral reimplantation or placing ureteral stent after end-to-end anastomosis,and 1 case received left kidney resection and GnRH-a or gestrinone for consolidation therapy after operation and the symptoms were disappeared.Conclusion Ureteral endometriosis can be effectively treated by operation and medication with good prognosis.