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Reproductive Biology and Endocrinology
Published in: Reproductive Biology and Endocrinology 1/2009

Open Access 01-12-2009 | Methodology

Laparoscopic conservative management of ureteral endometriosis: a survey of eighty patients submitted to ureterolysis

Authors: Marco Camanni, Luca Bonino, Elena Maria Delpiano, Paola Berchialla, Giuseppe Migliaretti, Alberto Revelli, Francesco Deltetto

Published in: Reproductive Biology and Endocrinology | Issue 1/2009

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Abstract

Background

this study aims to evaluate the effectiveness and safety of laparoscopic conservative management of ureteral endometriosis.

Methods

Eighty cases of histologically confirmed endometriosis affecting the ureter, 10 of which with bladder involvement were prospectively studied. In detail, patients were 13 women with ureteral stenosis (7 with hydronephrosis), 32 with circular lesions totally encasing the ureter, and 35 with endometriotic foci on the ureteral wall, but not completely encasing it. They were submitted to laparoscopic ureterolysis with or without partial cystectomy, ureteroneocistostomy. The rate of surgical complications, the recurrence rate, the patients' satisfaction rate was assessed during 22 months (median) follow-up.

Results

Laparoscopic ureterolysis was employed for all patients and set free the ureter from the disease in 95% of cases, whereas ureteroneocystostomy was necessary for 4 patients showing severe stenosis with hydronephrosis, among which 2 had intrinsic endometriosis of the ureteral muscularis. Three post-surgery ureteral fistulae occurred in cases with ureteral involvement longer than 4 cm: two cases were successfully treated placing double J catheter, the third needed ureteroneocistostomy. During follow-up, ureteral endometriosis recurred in 2 patients who consequently underwent ureteroneocystostomy. Most patients expressed high satisfaction rate throughout the whole follow-up period.

Conclusion

laparoscopic ureterolysis is effective and well tolerated in most cases of ureteral endometriosis. Ureteroneocystostomy is a better strategy for patients with extended (more than 4 cm) ureteral involvement or with severe stenosis with or without hydronephrosis.
Appendix
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Metadata
Title
Laparoscopic conservative management of ureteral endometriosis: a survey of eighty patients submitted to ureterolysis
Authors
Marco Camanni
Luca Bonino
Elena Maria Delpiano
Paola Berchialla
Giuseppe Migliaretti
Alberto Revelli
Francesco Deltetto
Publication date
01-12-2009
Publisher
BioMed Central
Published in
Reproductive Biology and Endocrinology / Issue 1/2009
Electronic ISSN: 1477-7827
DOI
https://doi.org/10.1186/1477-7827-7-109

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