Laparoscopic conservative management of ureteral endometriosis: a survey of eighty patients submitted to ureterolysis

被引:27
作者
Camanni, Marco [3 ]
Bonino, Luca [3 ]
Delpiano, Elena Maria [3 ]
Berchialla, Paola [2 ]
Migliaretti, Giuseppe [2 ]
Revelli, Alberto [1 ]
Deltetto, Francesco [3 ]
机构
[1] Dept Obstet & Gynecol Sci, Reprod Med & IVF Unit, I-10126 Turin, Italy
[2] Univ Turin, Dept Publ Hlth & Microbiol, I-10126 Turin, Italy
[3] GINTEAM Unit Minimally Invas Gynaecol, I-10125 Turin, Italy
关键词
DEEPLY INFILTRATING ENDOMETRIOSIS; URINARY-TRACT ENDOMETRIOSIS; PARTIAL CYSTECTOMY;
D O I
10.1186/1477-7827-7-109
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: this study aims to evaluate the effectiveness and safety of laparoscopic conservative management of ureteral endometriosis. Methods: Eighty cases of histologically confirmed endometriosis affecting the ureter, 10 of which with bladder involvement were prospectively studied. In detail, patients were 13 women with ureteral stenosis (7 with hydronephrosis), 32 with circular lesions totally encasing the ureter, and 35 with endometriotic foci on the ureteral wall, but not completely encasing it. They were submitted to laparoscopic ureterolysis with or without partial cystectomy, ureteroneocistostomy. The rate of surgical complications, the recurrence rate, the patients' satisfaction rate was assessed during 22 months (median) follow-up. Results: Laparoscopic ureterolysis was employed for all patients and set free the ureter from the disease in 95% of cases, whereas ureteroneocystostomy was necessary for 4 patients showing severe stenosis with hydronephrosis, among which 2 had intrinsic endometriosis of the ureteral muscularis. Three post-surgery ureteral fistulae occurred in cases with ureteral involvement longer than 4 cm: two cases were successfully treated placing double J catheter, the third needed ureteroneocistostomy. During follow-up, ureteral endometriosis recurred in 2 patients who consequently underwent ureteroneocystostomy. Most patients expressed high satisfaction rate throughout the whole follow-up period. Conclusion: laparoscopic ureterolysis is effective and well tolerated in most cases of ureteral endometriosis. Ureteroneocystostomy is a better strategy for patients with extended (more than 4 cm) ureteral involvement or with severe stenosis with or without hydronephrosis.
引用
收藏
页数:7
相关论文
共 28 条
[1]   Clinical aspects and surgical treatment of urinary tract endometriosis: Our experience with 31 cases [J].
Antonelli, Alessandro ;
Simeone, Claudio ;
Zani, Danilo ;
Sacconi, Tazio ;
Minini, Gianfranco ;
Canossi, Emma ;
Cunico, Sergio Cosciani .
EUROPEAN UROLOGY, 2006, 49 (06) :1093-1098
[2]   Sonography and MR imaging for the assessment of deep pelvic endometriosis [J].
Bazot, M ;
Daraï, E .
JOURNAL OF MINIMALLY INVASIVE GYNECOLOGY, 2005, 12 (02) :178-185
[3]   Anatomical distribution of deeply infiltrating endometriosis: surgical implications and proposition for a classification [J].
Chapron, C ;
Fauconnier, A ;
Vieira, M ;
Barakat, H ;
Dousset, B ;
Pansini, V ;
Vacher-Lavenu, MC ;
Dubuisson, JB .
HUMAN REPRODUCTION, 2003, 18 (01) :157-161
[4]   Laparoscopic management of bladder endometriosis [J].
Chapron, C ;
Dubuisson, JB .
ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA, 1999, 78 (10) :887-890
[5]  
CHAPRON C, 2009, FERTIL STER IN PRESS
[6]  
Chen Hsing-Yu, 2006, Taiwan J Obstet Gynecol, V45, P142
[7]   Operative management of deeply infiltrating endometriosis: Results on pelvic pain symptoms according to a surgical classification [J].
Chopin, N ;
Vieira, M ;
Borghese, B ;
Foulot, H ;
Dousset, B ;
Coste, J ;
Mignon, A ;
Fauconnier, A ;
Chapron, C .
JOURNAL OF MINIMALLY INVASIVE GYNECOLOGY, 2005, 12 (02) :106-112
[8]   Endometriosis of the urinary tract [J].
Comiter, CV .
UROLOGIC CLINICS OF NORTH AMERICA, 2002, 29 (03) :625-+
[9]   Iatrogenic ureterat lesions and repair:: A review for gynecotogists [J].
De Cicco, Carlo ;
Ret Davalos, Maria Lorena ;
Van Cleynenbreugel, Ben ;
Verguts, Jasper ;
Koninckx, Philippe Robert .
JOURNAL OF MINIMALLY INVASIVE GYNECOLOGY, 2007, 14 (04) :428-435
[10]  
Donnez J, 2004, BEST PRACT RES CL OB, V18, P329