Ureterendometriose

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This paper reviews ureteral endometriosis, illustrating diagnostic challenges and recommending ureteroneocystostomy with hormone treatment for preserved renal function while advising consideration of the condition in premenopausal women with distal ureteral complaints.

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This study examines the diagnostic and therapeutic challenges of ureteral endometriosis through an analysis of five clinical cases. The authors highlight that definitive diagnosis was frequently delayed until intraoperative rapid histological examination confirmed the findings in most instances. For patients with preserved renal function, the preferred treatment involved ureteroneocystostomy using the psoas hitch technique followed by hormonal therapy. Relevance to endometriosis: Centrally about the condition — specifically focusing on deep infiltrating endometriosis affecting the urinary tract and its surgical management.

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Abstract

In the literature, figures quoted for the involvement of the urinary tract range between 1% and 11%, adenomyosis being the exception rather than the rule. The problems of preoperative diagnosis are illustrated with reference to five of the author's cases. In four-fifths of the cases definitive confirmation of the findings was only obtained by intraoperative examination with a rapid incision. In cases with preserved renal function, ureteroneocystostomy employing the psoas hitch technique with subsequent hormone treatment was the treatment of choice. Summarizing, endometriosis should be considered in differential diagnosis in premenopausal women with unclear complaints and micturition disorders in the distal one-third of the ureter.
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Subscribe to RSS DOI: 10.1055/s-2008-1036649 © Georg Thieme Verlag Stuttgart · New York Ureterendometriose AdenomyosisPublication History Publication Date: 19 March 2008 (online) Zusammenfassung Die Literaturangaben über die Beteiligung des Harntraktes schwanken zwischen 1 und 11%, wobei die Ureterendometriose eher die Ausnahme darstellt. An 5 eigenen Fällen wird die Problematik der präoperativen Diagnostik dargestellt. Die endgültige Befundsicherung wurde in % der Fälle erst durch intraoperative Schnellschnittuntersuchung erbracht. Bei erhaltener Nierenfunktion bot sich die Ureterzystoneostomie in Psoas-Hitch-Technik mit hormoneller Nachbehandlung als Therapie der Wahl an. Als Fazit gilt es, bei prämenopausalen Frauen mit unklarem Beschwerdebild und Harnabflußstörungen im distalen Drittel des Ureters die Endometriose in die Differentialdiagnostik mit einzubeziehen. Abstract In the literature, figures quoted for the involvement of the urinary tract range between 1% and 11%, adenomyosis being the exception rather than the rule. The Problems of preoperative diagnosis are illustrated with reference to five of the author's cases. In four-fifths of the cases definitive confirmation of the findings was only obtained by intraoperative examination with a rapid incision. In cases with preserved renal function, ureteroneocystostomy employing the psoas hitch technique with subsequent hormone treatment was the treatment of choice. Summarizing, endometriosis should be considered in differential diagnosis in premenopausal women with unclear complaints and micturition disorders in the distal one-third of the ureter.

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Condition tags

endometriosisadenomyosis

MeSH descriptors

Endometriosis Ureteral Neoplasms Diagnosis, Differential Endometriosis Endometriosis Endometriosis Female Humans Ureter Ureter Ureteral Neoplasms Ureteral Neoplasms Ureteral Neoplasms Urography

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