Endometriosis Research Today is a free monthly online journal that collates and summarizes the latest research about Endometriosis, including details on causes, treatment, symptoms, infertility. | ||||||||
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Outcome of laparoscopic ureterolysis for ureteral endometriosis.Ghezzi F, Cromi A, Bergamini V, Serati M, Sacco A, Mueller MD Department of Obstetrics and Gynecology, University of Insubria, Del Ponte Hospital, Varese, Italy. fabio.ghezzi@uninsubria.it 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. Published 2 August 2006 in Fertil Steril, 86(2): 418-22.
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