Ureteral Endometriosis: Proposal for a Diagnostic and Therapeutic Algorithm with a Review of the Literature

Carmen Maccagnano, Federico Pellucchi, Lorenzo Rocchini, Massimo Ghezzi, Vincenzo Scattoni, Francesco Montorsi, Patrizio Rigatti, Renzo Colombo
Urologia internationalis · 2013 · vol. 91(1) , pp. 1–9 · doi:10.1159/000345140 · PMID:23689345 · W2065974358
review OA: bronze CC0 ⤵ 78 in-corpus citations
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This literature review analyzed over 200 cases of ureteral endometriosis, identifying intrinsic and extrinsic pathological types and proposing a diagnostic and therapeutic algorithm based on lesion characteristics.

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Abstract

INTRODUCTION: The ureteral involvement in deep pelvic endometriosis in usually asymptomatic and might lead to a silent loss of renal function. As a matter of fact, the diagnosis and the treatment modalities are still a matter of debate. MATERIALS AND METHODS: We performed a literature review by searching the MEDLINE database for articles published in English between 1996 and 2010, using the key words urinary tract endometriosis, ureteral endometriosis, diagnosis and treatment. We found more than 200 cases of ureteral endometriosis (UE). RESULTS: The disease most commonly affects a single distal segment of the ureter, with a left predisposition in most of the patients. Two major pathological types of UE may be distinguished: intrinsic and extrinsic. The symptoms are usually nonspecific and owing to secondary obstruction. The diagnosis has to be considered as a step- by-step procedure, starting from physical examination to highly detailed imaging methods. Nowadays, the treatment is usually chosen according to the type of UE, the site lesion and the distance to the ureteral orifice, with the use of JJ stents remaining a matter of debate. CONCLUSIONS: A close collaboration between the gynecologist and the urologist is advisable, especially in referral centers. Surgical treatment can lead to good results in terms of both patient compliance and prognosis.

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Condition tags

mesh:D004715endometriosis

MeSH descriptors

Endometriosis Endometriosis Ureter Ureteral Diseases Ureteral Diseases Algorithms Diagnosis, Differential Endometriosis Female Humans Magnetic Resonance Imaging Prognosis Stents Ureter Ureteral Diseases

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 (70)

Cited by (50)

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License: CC0 · commercial use OK