Clinical Characteristics and Surgical Treatment of Ureteral Endometriosis: Our Experience with 40 Cases

Kunlin Yang, Sida Cheng, Yukun Cai, Jiankun Qiao, Yangyang Xu, Xinfei Li, Shengwei Xiong, Ye Lu, Aobing Mei, Xuesong Li, Liqun Zhou
In: Research Square · 2020 · doi:10.21203/rs.3.rs-72716/v1 · W4244840074
preprint OA: green CC0 ⤵ 1 in-corpus citation
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This retrospective analysis of 40 ureteral endometriosis cases reports on surgical outcomes, finding ureteroureterostomy and ureteroneocystostomy effective for severe disease with an 89% success rate.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This retrospective single-center study analyzed 40 pathology-proven cases of ureteral endometriosis (UE) with intraoperative ureteral involvement from May 2004 to May 2020, describing clinical characteristics, renal function, surgical approaches, and outcomes. All patients had hydronephrosis and, when assessed, the affected kidney’s mean glomerular filtration rate was significantly worse than the healthy side (23.4 vs 54.9 ml/min); surgeries included ureteroureterostomy (30%), ureteroneocystostomy (55%), and nephroureterectomy (13%), with 70% achieving success defined as symptom/hydronephrosis relief (25/28) over a median 71-month follow-up. The authors note limitations including incomplete follow-up data (only 28/40 were followed, with 10 unreachable and 2 with too-short follow-up) and that the work is based on their single-center experience rather than a controlled comparison. Relevance to endometriosis: the entire paper focuses on ureteral endometriosis and summarizes its diagnosis, surgical management, and outcomes, directly relating to endometriosis.

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Abstract

Abstract Background: To present the experience of surgical management of ureteral endometriosis (UE) in our single center. Methods: A retrospective analysis of 40 cases of UE who had intraoperative surgical findings of endometriosis involving the ureter and pathology-proven UE. Results: Forty patients (median age, 42.5 years) with histologic evidence of UE were included. Six (15%) patients had history of endometriosis. Twenty-one (52%) patients had urological symptoms and 19 (48%) patients were asymptomatic. All patients had hydronephrosis. The mean glomerular filtration rate of the affected-side kidney was significantly worse than the healthy-side one (23.4 vs 54.9 ml/min; P < 0.001). Twelve (30%) patients were treated with ureteroureterostomy (11 open approaches and 1 robotic approach). Twenty-two (55%) patients underwent ureteroneocystostomy (17 open approaches, 4 laparoscopic approaches and 1 robotic approach). Five patients underwent nephoureterectomy. One patient refused the aggressive surgery and received ureteroscopic biopsy and ureteral stent placement. Thirteen (33%) cases were required gynecological operations. Three (8%) patients in open group suffered from major surgical complications. Nine (24%) patients received postoperative endocrine therapy. Twenty-eight (70%) patients were followed up (median follow-up time, 71 months). The success rate was 25/28 (89%). Conclusions: Although UE is rare, early diagnosis and treatment of UE will help reduce the morbidity of this disease. Most of time, A multidisciplinary team is necessary. For the patients with severe UE, segmentally ureteral resection with UU or ureteroneocystostomy may be a good choice.

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endometriosis

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