VP05.12: The CLINUS model: building a prediction model for ureterolysis in laparoscopic endometriosis surgery

This study's objective was to develop a model to predict the need for ureterolysis (i.e. dissection of the ureter) during laparoscopy for endometriosis. Ureterolysis may be considered an advanced laparoscopic procedure not usually performed by general gynecologists. A retrospective observational study of 177 women who had deep endometriosis ultrasounds and subsequent laparoscopy +/- excision of endometriosis at a local health district between January 2017 and February 2021 was conducted. Of 177 patients analysed, 91 (47.6%) had a ureterolysis performed at the surgery. The major preoperative predictors were clinical dyschezia, negative sliding sign and immobility of ovaries during the transvaginal ultrasound. For clinical dyschezia, PPV 56% and NPV 65.1% (P = 0.004). Chi-squared tests showed significant associations of ureterolysis intraoperatively with the uterine and ovaries negative sliding sign (table 1). Our model suggests that clinical and sonographic features can be used to predict the need for ureterolysis during surgery, enabling us to select in advance what resources may be needed, including an advanced gynecologic laparoscopic surgery team. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.