OBJECTIVE: To evaluate the adequacy of laparoscopic ureterolysis as a primary treatment option for ureteral endometriosis. DESIGN: Prospective collaborative cohort study. SETTING: Gynecologic departments of three university hospitals. PATIENT(S): Women with ureteral endometriosis exhibiting moderate-to-severe hydronephrosis on preoperative intravenous pyelography. INTERVENTION(S): Laparoscopic ureterolysis. MAIN OUTCOME MEASURE(S): Cure rate, disesase recurrence. RESULT(S): Thirty-three patients underwent laparoscopic ureterolysis during the study period. Bilateral involvement of ureters was found in 4 (12.1%) cases. In women with unilateral lesions the left ureter was more frequently affected (24/29 vs. 5/29). Ureteral involvement was associated with uterosacral ligaments endometriosis in 65.5% (22/34) of cases. No inadvertent ureteral injuries occurred during ureterolysis. A partial wall resection of the ureter was necessary in one case and a segmental ureteral resection with vescicopsoas hitch was required in a women with intrinsic ureteral endometriosis. The median (range) follow-up time was 16 months (range: 3-53 months). Thirty-two patients (96.7%) had a patent ureter on the 3-month postoperative intravenous pyelography. The recurrence rate of ureteral lesions was 12.1% (4/33). CONCLUSION(S): Our findings suggest that a conservative laparoscopic approach is an effective treatment option in most patients with ureteral endometriosis exhibiting moderate-to-severe hydronephrosis.
OBJECTIVE: To evaluate the adequacy of laparoscopic ureterolysis as a primary treatment option for ureteral endometriosis. DESIGN: Prospective collaborative cohort study. SETTING: Gynecologic departments of three university hospitals. PATIENT(S): Women with ureteral endometriosis exhibiting moderate-to-severe hydronephrosis on preoperative intravenous pyelography. INTERVENTION(S): Laparoscopic ureterolysis. MAIN OUTCOME MEASURE(S): Cure rate, disesase recurrence. RESULT(S): Thirty-three patients underwent laparoscopic ureterolysis during the study period. Bilateral involvement of ureters was found in 4 (12.1%) cases. In women with unilateral lesions the left ureter was more frequently affected (24/29 vs. 5/29). Ureteral involvement was associated with uterosacral ligaments endometriosis in 65.5% (22/34) of cases. No inadvertent ureteral injuries occurred during ureterolysis. A partial wall resection of the ureter was necessary in one case and a segmental ureteral resection with vescicopsoas hitch was required in a women with intrinsic ureteral endometriosis. The median (range) follow-up time was 16 months (range: 3-53 months). Thirty-two patients (96.7%) had a patent ureter on the 3-month postoperative intravenous pyelography. The recurrence rate of ureteral lesions was 12.1% (4/33). CONCLUSION(S): Our findings suggest that a conservative laparoscopic approach is an effective treatment option in most patients with ureteral endometriosis exhibiting moderate-to-severe hydronephrosis.
Authors: Alessandra Spinelli; Silvia Contri; Andrea Savino; Francesco De Antonis; Maria Boddi Journal: Intern Emerg Med Date: 2013-05-29 Impact factor: 3.397
Authors: Stéfanie A Seixas-Mikelus; Susan J Marshall; D Dawon Stephens; Aaron Blumenfeld; Eric D Arnone; Khurshid A Guru Journal: JSLS Date: 2010 Apr-Jun Impact factor: 2.172
Authors: Marco Camanni; Luca Bonino; Elena Maria Delpiano; Paola Berchialla; Giuseppe Migliaretti; Alberto Revelli; Francesco Deltetto Journal: Reprod Biol Endocrinol Date: 2009-10-12 Impact factor: 5.211