Laparoscopic surgery for severe ureteric endometriosis
Ignacio Miranda-Mendoza1, Elias Kovoor, Joseph Nassif
1IRCAD/EITS and Strasbourg University Hospitals, Faculty of Medicine, Strasbourg, France. ignaciomir@med.uchile.cl
Summary
Laparoscopic surgery effectively treats severe ureteric endometriosis, improving pain and kidney function. Complete disease excision is key to preventing recurrence and long-term complications like stenosis.
Area of Science:
- Gynecology
- Urology
- Surgical Oncology
Background:
- Ureteric endometriosis, a severe complication of deep infiltrative endometriosis (DIE), can lead to significant ureteral damage and non-functioning kidneys.
- Early diagnosis and intervention are crucial for managing ureteric endometriosis and preserving renal function.
Purpose of the Study:
- To evaluate the clinical and surgical outcomes of laparoscopic procedures for severe ureteric endometriosis.
- To assess the feasibility and efficacy of laparoscopic ureterolysis and ureteral anastomosis in managing ureteric endometriosis.
Main Methods:
- Retrospective descriptive study of 13 patients with severe ureteric endometriosis undergoing laparoscopic surgery.
- Procedures included ureterolysis, end-to-end anastomosis, and ureteral stenting.
- Data collected from patient records and follow-up interviews.
Main Results:
- Laparoscopic treatment was feasible in all cases, with no intraoperative complications.
- Seven patients (53.8%) underwent ureterolysis, and six (46.2%) had segmental resection with end-to-end anastomosis.
- All patients experienced pain improvement; three (23%) had major postoperative complications. Ureteric wall infiltration was present in 30.8%.
Conclusions:
- Laparoscopic surgery is a feasible and effective treatment for severe ureteric endometriosis.
- Complete excision of endometriosis is essential for symptom improvement and preventing recurrence.
- Imaging should be used to exclude ureteric involvement in patients with deep endometriosis; long-term follow-up is necessary to monitor for stenosis.
Related Concept Videos
01:25Urinary Tract Calculi VI: Surgical Management
Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
01:28Urologic Endoscopic Procedure: Cystoscopic Examination
Meaning of Cystoscopic Examination:Cystoscopy is an essential diagnostic tool in urology that is used to assess the structure and function of the genitourinary system. It provides a direct view of the urethra, bladder, and, in some cases, the ureteral openings. This procedure helps detect structural abnormalities, infections, cancers, and blockages in the urinary tract. There are two types of cystoscopy:Flexible cystoscopy is commonly performed in outpatient settings due to its less invasive...