Ureteral Endometriosis Treated with Laparoscopic Ureteral Resection and Primary Anastomosis: Report of a Case

- 期刊 子宮內膜異位症是第二常見之婦女疾病。通常發生在女性內生殖器及骨盆腔。但已有文獻報告其它罕見之發生部位，包括泌尿道。在此，我們報告一位患有子宮腺肌症及輸尿管狹窄的四十四歲女性，於腹腔鏡子宮切除及暫時性輸尿管導管放置後，仍反覆產生左側腎積水。輸尿管鏡檢查發現在下段輸尿管有息肉樣病變，並以腹腔鏡行輸尿管部份切除及吻合手術。病理報告証實為子宮內膜異位症。於四個月之追蹤期並無復發之情形。對於某些選擇性病患腹腔鏡手術是具有微創特性的適當治療方式。 Endometriosis accounts for the second most common gynecologic disease in women. It occurs commonly in the female internal genital organs and pelvic cavity. Other rare sites including the urinary tract have however been reported in the literature. Herein, we present a 44-year-old woman with left lower ureteral stricture and repeated hydronephrosis despite temporary ureteral stenting after laparoscopic hysterectomy for adenomyosis. Ureteroscopy revealed a circumferential polypoid lesion in left lower ureter and she received 4-port transperitoneal laparoscopic segmental resection of the ureter and reanastomosis of ureter. Extrinsic ureteral endometriosis was confirmed by pathologic examination. There was no recurrence during 4-month followup. Laparoscopic resection offers minimal invasiveness and adequate treatment for this entity in selected cases.