Retrocervical deep infiltrating endometriotic lesions larger than thirty millimeters are associated with an increased rate of ureteral involvement

STUDY OBJECTIVE: To estimate the presence of ureteral involvement in deep infiltrating endometriosis (DIE) affecting the retrocervical area. DESIGN: Retrospective study of women undergoing laparoscopic treatment of DIE affecting the retrocervical area. DESIGN CLASSIFICATION: Canadian Task Force classification II-3. SETTING: Tertiary referral private hospital. PATIENTS: We evaluated 118 women who underwent laparoscopy for the treatment of retrocervical DIE lesions between January 2010 and March 2012. INTERVENTIONS: All women underwent laparoscopic surgery for the complete treatment of DIE. After surgery all specimens were sent for pathologic examination to confirm the presence of endometriosis. MEASUREMENTS: Patients with pathologically-confirmed retrocervical DIE were divided into 2 groups according to the size of the lesion (group 1: lesions ≥ 30 mm; group 2: lesions < 30 mm) and the rate of ureteral endometriosis was compared between both groups. MAIN RESULTS: Ureteral involvement was present in 17.9% (95% confidence interval [CI] 10%-29.9%) of women with retrocervical lesions ≥ 30 mm whereas in only 1.6% (95% CI 0.4%-8.5%) of those with lesions <30 mm (odds ratio = 13.3 [95% CI 1.6-107.3]). CONCLUSION: Patients undergoing surgery for retrocervical DIE lesions ≥ 30 mm in diameter have a greater risk of having ureteral involvement (17.9%).