Clinical characteristics and surgical treatment of ureteral endometriosis: our experience with 40 cases
Abstract Background To present the experience with the surgical management of ureteral endometriosis (UE) in our single center. Methods To present the experience with the surgical management of ureteral endometriosis (UE) in our single center. A retrospective analysis of 40 patients with UE who pres...
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| Format: | Article |
| Language: | English |
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BMC
2021-05-01
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| Series: | BMC Women's Health |
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| Online Access: | https://doi.org/10.1186/s12905-021-01349-7 |
| _version_ | 1818602485184462848 |
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| author | Kunlin Yang Sida Cheng Yukun Cai Jiankun Qiao Yangyang Xu Xinfei Li Shengwei Xiong Ye Lu Aobing Mei Xuesong Li Liqun Zhou |
| author_facet | Kunlin Yang Sida Cheng Yukun Cai Jiankun Qiao Yangyang Xu Xinfei Li Shengwei Xiong Ye Lu Aobing Mei Xuesong Li Liqun Zhou |
| author_sort | Kunlin Yang |
| collection | DOAJ |
| description | Abstract Background To present the experience with the surgical management of ureteral endometriosis (UE) in our single center. Methods To present the experience with the surgical management of ureteral endometriosis (UE) in our single center. A retrospective analysis of 40 patients with UE who presented with intraoperative surgical findings of endometriosis involving the ureter and pathology-proven UE was performed. Results Forty patients (median age, 42.5 years) with histological evidence of UE were included. Six (15%) patients had a history of endometriosis. Twenty-one (52%) patients had urological symptoms, and 19 (48%) patients were asymptomatic. All patients had hydronephrosis. The mean glomerular filtration rate (GFR) of the ipsilateral kidney was significantly worse than that of the contralateral kidney (23.4 vs 54.9 ml/min; P < 0.001). Twelve (30%) patients were treated with ureteroureterostomy (11 open approaches and 1 robotic approach). Twenty-two (55%) patients underwent ureteroneocystostomy (17 open approaches, 4 laparoscopic approaches and 1 robotic approach). Five patients underwent nephroureterectomy. One patient refused aggressive surgery and received ureteroscopic biopsy and ureteral stent placement. Thirteen (33%) patients required gynecological operations. Three (8%) patients in the open group suffered from major surgical complications. Nine (24%) patients received postoperative endocrine therapy. Twenty-eight (70%) patients were followed up (median follow-up time, 71 months). Twenty-four patients received kidney-sparing surgeries. The success rate for these 24 patients was 21/24 (87.5%). The success rates of ureteroneocystostomy and ureteroureterostomy were 15/16 (93.8%) and 5/7 (71.4%), respectively. Conclusions Although UE is rare, we should remain vigilant for the disease among female patients with silent hydronephrosis. Typically, a multidisciplinary surgical team is necessary. For patients with severe UE, segmental ureteral resection with ureteroureterostomy (UU) or ureteroneocystostomy may be a preferred choice. |
| first_indexed | 2024-12-16T13:08:01Z |
| format | Article |
| id | doaj.art-8308b63df4b84f2faf3856688a0129ca |
| institution | Directory Open Access Journal |
| issn | 1472-6874 |
| language | English |
| last_indexed | 2024-12-16T13:08:01Z |
| publishDate | 2021-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Women's Health |
| spelling | doaj.art-8308b63df4b84f2faf3856688a0129ca2022-12-21T22:30:41ZengBMCBMC Women's Health1472-68742021-05-012111710.1186/s12905-021-01349-7Clinical characteristics and surgical treatment of ureteral endometriosis: our experience with 40 casesKunlin Yang0Sida Cheng1Yukun Cai2Jiankun Qiao3Yangyang Xu4Xinfei Li5Shengwei Xiong6Ye Lu7Aobing Mei8Xuesong Li9Liqun Zhou10Department of Urology, Peking University First HospitalDepartment of Urology, Peking University First HospitalDepartment of Urology, Peking University First HospitalDepartment of Urology, Peking University First HospitalDepartment of Urology, Peking University First HospitalDepartment of Urology, Peking University First HospitalDepartment of Urology, Peking University First HospitalDepartment of Obstetrics and Gynecology, Peking University First HospitalDepartment of Urology, The Second People’s Hospital of GuiyangDepartment of Urology, Peking University First HospitalDepartment of Urology, Peking University First HospitalAbstract Background To present the experience with the surgical management of ureteral endometriosis (UE) in our single center. Methods To present the experience with the surgical management of ureteral endometriosis (UE) in our single center. A retrospective analysis of 40 patients with UE who presented with intraoperative surgical findings of endometriosis involving the ureter and pathology-proven UE was performed. Results Forty patients (median age, 42.5 years) with histological evidence of UE were included. Six (15%) patients had a history of endometriosis. Twenty-one (52%) patients had urological symptoms, and 19 (48%) patients were asymptomatic. All patients had hydronephrosis. The mean glomerular filtration rate (GFR) of the ipsilateral kidney was significantly worse than that of the contralateral kidney (23.4 vs 54.9 ml/min; P < 0.001). Twelve (30%) patients were treated with ureteroureterostomy (11 open approaches and 1 robotic approach). Twenty-two (55%) patients underwent ureteroneocystostomy (17 open approaches, 4 laparoscopic approaches and 1 robotic approach). Five patients underwent nephroureterectomy. One patient refused aggressive surgery and received ureteroscopic biopsy and ureteral stent placement. Thirteen (33%) patients required gynecological operations. Three (8%) patients in the open group suffered from major surgical complications. Nine (24%) patients received postoperative endocrine therapy. Twenty-eight (70%) patients were followed up (median follow-up time, 71 months). Twenty-four patients received kidney-sparing surgeries. The success rate for these 24 patients was 21/24 (87.5%). The success rates of ureteroneocystostomy and ureteroureterostomy were 15/16 (93.8%) and 5/7 (71.4%), respectively. Conclusions Although UE is rare, we should remain vigilant for the disease among female patients with silent hydronephrosis. Typically, a multidisciplinary surgical team is necessary. For patients with severe UE, segmental ureteral resection with ureteroureterostomy (UU) or ureteroneocystostomy may be a preferred choice.https://doi.org/10.1186/s12905-021-01349-7UreteralendometriosisUreteroureterostomyUreteroneocystostomyNephroureterectomyCase report |
| spellingShingle | Kunlin Yang Sida Cheng Yukun Cai Jiankun Qiao Yangyang Xu Xinfei Li Shengwei Xiong Ye Lu Aobing Mei Xuesong Li Liqun Zhou Clinical characteristics and surgical treatment of ureteral endometriosis: our experience with 40 cases BMC Women's Health Ureteralendometriosis Ureteroureterostomy Ureteroneocystostomy Nephroureterectomy Case report |
| title | Clinical characteristics and surgical treatment of ureteral endometriosis: our experience with 40 cases |
| title_full | Clinical characteristics and surgical treatment of ureteral endometriosis: our experience with 40 cases |
| title_fullStr | Clinical characteristics and surgical treatment of ureteral endometriosis: our experience with 40 cases |
| title_full_unstemmed | Clinical characteristics and surgical treatment of ureteral endometriosis: our experience with 40 cases |
| title_short | Clinical characteristics and surgical treatment of ureteral endometriosis: our experience with 40 cases |
| title_sort | clinical characteristics and surgical treatment of ureteral endometriosis our experience with 40 cases |
| topic | Ureteralendometriosis Ureteroureterostomy Ureteroneocystostomy Nephroureterectomy Case report |
| url | https://doi.org/10.1186/s12905-021-01349-7 |
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