Analysis of 33 cases with ureteral endometriosis

Objective To investigate the diagnosis and treatment of ureteral endometriosis.Methods We performed a retrospective study of 33cases diagnosed as ureteral endometriosis with surgery confirmed in Peking University First Hospital from January 2000to October 2013.Results The prevalence of ureteral endometriosis was 1.1%,with an average age of(41.3±5.8)years.Among the 33cases,urological symptoms and pelvic pain including dysmenorrheal,periodic abdominal pain and osphyalgia were the main clinical characters,while there were 6 patients were asymptomatic.All patients with ureter endometriosis had hydronephrosis and hydroureter before surgery,hydronephrosis were right sided in 19patients,left sided in 14patients.The distal and middle sections of ureteral obstructions existed in 29patients and 4patients.Nine patients presented with intrinsic lesions.Laparotomy was performed in 18patients,others were under laparoscopy surgery.Ureterolysis,ureteroureterostomy,ureteroneocystostomy and unilateral nephrectomy were performed in 10,13,6and 4patients separately.The median followup time was 53.4 months with 8cases lost.During the follow-up period,hydronephrosis recurred in 1patient. Conclusion Because of the lack of specific symptoms,ureteral endometriosis potentially lead to serious consequences which should received additional consideration.Surgery is the best treatment for remove endometriotic lesions and relieve ureteral obstruction.