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Related Experiment Videos

[Ureteral endometriosis: urological features].

Ezio Frego1, Alessandro Antonelli, Luigi Tralce

  • 1Divisione Clinicizzata di Urologia, Università degli Studi di Brescia.

Archivio Italiano Di Urologia, Andrologia : Organo Ufficiale [Di] Societa Italiana Di Ecografia Urologica E Nefrologica
|June 11, 2002
PubMed
Summary

Severe ureteral endometriosis, though rare, requires prompt diagnosis and treatment. Ureteric resection with ureteroneocystostomy offers the best long-term cure rates for this challenging condition.

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Area of Science:

  • Urology
  • Gynecology
  • Surgical Oncology

Background:

  • Endometriosis affects 10-20% of premenopausal women; ureteral involvement is rare (0.1-0.4%).
  • Clinical and radiological features of ureteral endometriosis are non-specific, complicating preoperative diagnosis.
  • Intravenous urography is essential for diagnosing pelvic endometriosis with potential ureteral compromise.

Purpose of the Study:

  • To evaluate treatment outcomes for severe ureteral endometriosis.
  • To identify the most effective surgical approach for ureteral endometriosis.

Main Methods:

  • Retrospective review of 10 patients with severe ureteral endometriosis (1995-2001).
  • Surgical interventions included bilateral stenting with hormonal therapy, ureteral resection with primary reanastomosis, and ureteric resection with ureteroneocystostomy.

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  • Follow-up included assessment for recurrence and long-term outcomes.
  • Main Results:

    • One patient with bilateral ureteral endometriosis treated with stenting and hormonal therapy had good results.
    • Two patients underwent ureteral resection with primary reanastomosis; one experienced relapse requiring secondary surgery.
    • Seven patients treated with ureteric resection and ureteroneocystostomy showed no recurrences (median follow-up 31 months).

    Conclusions:

    • Ureteric resection combined with ureteroneocystostomy provides the best chance for curing severe ureteral endometriosis.
    • Adjuvant hormonal therapy or hysteroadnexiectomy is crucial for minimizing relapse risk.
    • Early diagnosis and appropriate surgical management are vital for favorable patient outcomes.