ABSTRACT
OBJECTIVE: To investigate the clinical characteristics and the feasibility of laparoscopic treatment of ureteral endometriosis.METHODS: Retrospective analysis of the clinical characteristics,treatment methods and prognosis of 16 patients with ureteral endometriosis from Renji Hospital of Shanghai Jiao Tong University School of Medicine from January 2015 to February 2017.RESULTS: Ureteral stricture is the main symptom for all these 16 patients.15 patients merged with other deep infiltrating endometriosis(DIE)(15/16).All patients underwent laparoscopic surgery.Ureterolysis plus ureteral stent placement were performed in 8 patients,while laparoscopic ureteroneocystostomy in 6 and 2 abandoned surgery.Radical resection of DIE lesions were performed in 15 patients,hysterectomy in 4 patients,adenomyotomy in 2 patients,one-sided or double-sided ovarian cyst removal in 5 patients,ovariocystectomy and adnexectomy in 3 patients.More than 2 surgeries were performed in 1 patient.15 patients preserve ovarian function.No serious postoperative complications.CONCLUSION: Ureteral endometriosis is rare and difficult to diagnosis as lacking of specific symptoms.Laparoscopic treatment can achieve satisfactory therapeutic outcome.
ABSTRACT
Endometriosis is a relatively common disease, affecting 5-10% of women of reproductive age. But, endometriosis affecting the urinary tract is very rare entity. Involvement of urinary tract by endometriosis occurs in about 1% of women with pelvic endometriosis. Ureteral endometriosis is mostly asymptomatic for a long time, and associated with nonspecific symptoms at clinical presentation and difficult preoperative diagnosis. The involvement of the ureter is rarely intrinsic by implantation of endometrial tissue in the wall of the ureter, but rather due to external compression by adjacent endometriosis and its attendant inflammation and fibrosis. We have experienced a case of right severe hydroureteronephrosis due to ureteral stricture from endometriosis. Laparoscopic nephrectomy was done due to renal atrophy. At the same time, laparoscopic total hysterectomy with right salpingo-oophorectomy was performed because of the uterine adenomyosis and right ovarian endometrioma. So, we report that with a brief review of literatures.
Subject(s)
Female , Humans , Adenomyosis , Atrophy , Constriction, Pathologic , Diagnosis , Endometriosis , Fibrosis , Hydronephrosis , Hysterectomy , Inflammation , Nephrectomy , Ureter , Urinary TractABSTRACT
Endometriosis affecting the urinary tract is very rare disease. The ureteral endometriosis is mostly asymptomatic for a long time, and associated with nonspecific symptoms such as abdominal or flank pain, renal colic, voiding difficulty and gross hematuria. Radiologic and laboratory findings show nonspecific findings, and the diagnosis is difficult. We report a case of obstructive ureteral endometriosis associated with right hydronephorsis. This case is operated under the impression of direct compression of ureter by uterine myoma. Total abdominal hysterectomy and ureteroureterostomy were performed. Final diagnosis of ureteral endometriosis is documented by pathologic findings.
Subject(s)
Female , Diagnosis , Endometriosis , Flank Pain , Hematuria , Hydronephrosis , Hysterectomy , Leiomyoma , Rare Diseases , Renal Colic , Ureter , Urinary TractABSTRACT
Extragenital endometriosis makes up 10-15%. The most common site is gastrointestinal tract. In urinary tract, endometriosis of urethra makes up 0.6%, of bladder is 37.6%, of ureter is 61.2%. 89% of ureteral lesions develop laterally. Cause of endometriosis has been unknown. Several hypotheses are available. It can be treated by medication, surgery or by combining the medication with surgery or can be left without treatment. Each procedure is indicated depend on clinical situation, site of tumor, progress of disease, medication and equipment condition and clinician’s knowledge
Subject(s)
Ureteral Diseases , EndometriosisABSTRACT
A case of unilateral ureteral obstruction owing to ureteral endometriosis is presented. Endometriosis in the genitourinary tract, especially, ureteral endometriosis is well known but uncommon disease. Obstructive uropathy secondary to endometriosis of the ureter has been reported sporadically since Cullen (1917) first reported an example of bilateral involvement of the ureter. In a recent review of literature, there have been more than 90 cases reported during the last decade. This case is operated under the impression of Rt. ureteral tuberculosis and documented by pathologic findings."