Laparoscopic conservative management of ureteral endometriosis

Camanni M, Marco Camanni, Elena Maria Delpiano, Delpiano EM, Elena M Delpiano, Luca Bonino, Bonino L, Deltetto F, Francesco Deltetto
Current opinion in obstetrics & gynecology · 2010 · vol. 22(4) , pp. 309–314 · doi:10.1097/gco.0b013e32833beacc · PMID:20610998 · W1978304544
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-09 ⓘ

This review examines surgical strategies for ureteral endometriosis, proposing ureterolysis as an initial step but ureteroneocystostomy for severe cases and highlighting the surgeon's critical role in treatment decisions.

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⚙ AI-generated deep summary by qwen3.7-flash, 2026-08-20 · read from full text ⓘ

This review examines the complex surgical management of deeply infiltrating endometriosis involving the ureter, highlighting the challenge of balancing complete lesion excision with the avoidance of radical surgery morbidity. The authors discuss conservative strategies, suggesting that ureterolysis serves as an appropriate initial step for many patients, while ureteroneocystostomy is preferred for those with severe stenosis, hydronephrosis, or high risks of intrinsic disease. A major limitation noted is the absence of a clear, universally accepted surgical strategy due to the rarity of the condition, emphasizing the critical role of the primary surgeon’s judgment in determining the optimal approach. This paper is centrally about endometriosis — specifically the laparoscopic conservative management of deep infiltrating lesions affecting the ureter.

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Abstract

PURPOSE OF REVIEW: The surgical management of deeply infiltrating endometriosis involving the ureter is a complex procedure that requires an accurate balance between the need for complete excision of endometriotic foci and the need to avoid any morbidity associated with radical surgery. Owing to its rarity, a clear surgical strategy to deal with this condition (e.g. ureterolysis vs. ureteroneocystostomy) has not as yet been identified. RECENT FINDINGS: A few studies present data about the conservative management of ureteral endometriosis. We reported the experience of some surgical topics dealing with ureteral endometriosis and their strategies for the conservative treatment of this condition. SUMMARY: Ureterolysis could be used as the initial surgical step for patients with ureteral endometriosis. For patients displaying extended severe ureteral involvement, stenosis, or moderate or severe hydronephrosis with a high risk of having intrinsic ureteral disease, ureteroneocystostomy is likely to be a wiser surgical strategy. Moreover the crucial role of the primary surgeon in the treatment definition will hardly be replaced by objective reproducible referral pattern.
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Laparoscopic conservative management of ureteral endometriosis - Marco Camanni - Elena M Delpiano - Luca Bonino - Francesco Deltetto Purpose of review The surgical management of deeply infiltrating endometriosis involving the ureter is a complex procedure that requires an accurate balance between the need for complete excision of endometriotic foci and the need to avoid any morbidity associated with radical surgery. Owing to its rarity, a clear surgical strategy to deal with this condition (e.g. ureterolysis vs. ureteroneocystostomy) has not as yet been identified. Recent findings A few studies present data about the conservative management of ureteral endometriosis. We reported the experience of some surgical topics dealing with ureteral endometriosis and their strategies for the conservative treatment of this condition. Summary Ureterolysis could be used as the initial surgical step for patients with ureteral endometriosis. For patients displaying extended severe ureteral involvement, stenosis, or moderate or severe hydronephrosis with a high risk of having intrinsic ureteral disease, ureteroneocystostomy is likely to be a wiser surgical strategy. Moreover the crucial role of the primary surgeon in the treatment definition will hardly be replaced by objective reproducible referral pattern.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Laparoscopy Ureteral Diseases Endometriosis Female Gynecologic Surgical Procedures Gynecologic Surgical Procedures Humans Laparoscopy Ureteral Diseases Urologic Surgical Procedures Urologic Surgical Procedures

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.

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