1842 MINIMALLY INVASIVE LAPAROSCOPIC MANAGEMENT OF URETERAL ENDOMETRIOSIS. PROSPECTVE ANALYSIS OF 54 CASES WITH A MEAN FOLLOW UP OF 36 MONTHS

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Female Urology (II)1 Apr 20131842 MINIMALLY INVASIVE LAPAROSCOPIC MANAGEMENT OF URETERAL ENDOMETRIOSIS. PROSPECTVE ANALYSIS OF 54 CASES WITH A MEAN FOLLOW UP OF 36 MONTHS Oskar Kaufmann, Heloisa Ferreira Brudniewski, Winston Chen, and Rosa Maria Neme Oskar KaufmannOskar Kaufmann Sao Paulo, Brazil More articles by this author , Heloisa Ferreira BrudniewskiHeloisa Ferreira Brudniewski Sao Paulo, Brazil More articles by this author , Winston ChenWinston Chen Sao Paulo, Brazil More articles by this author , and Rosa Maria NemeRosa Maria Neme Sao Paulo, Brazil More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2261AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Endometriosis of the urinary tract is rare, compromising 1% to 2% of all endometriosis cases. Most cases are localized in the bladder (84%) or in the lower third of the ureter (10%). The aim of the study was to evaluate prospectively the efficacy of laparoscopic management of ureteral endometriosis. METHODS We have prospectively followed 54 patients presenting with ureteral endometriosis from October 2008 to October 2012. RESULTS From 635 endometriosis cases operated from October 2008 to October 2012 in a private clinic, we have found an incidence of 8.5% (54 cases) with preoperative evidence of moderate-severe ureter dilatation. Dysmenorrhea (91%) and dyspareunia (68%) were the symptoms more frequently reported; but only 29.6% (16 patients) had urinary symptoms and one patient had renal exclusion. In 51 cases, laparoscopic ureterolysis and resection of endometriosis was done, in two laparotomic ureterocystoneostomy, and in 1 laparoscopic nephrectomy was performed. In 23 cases we had associated bladder lesions simply treated by laparoscopic resection. No major complications were found. The left ureter was affected in 83 % (n=45) of cases and disease was bilateral in just 2 cases. Median follow-up time was 36 months. CONCLUSIONS Laparoscopic diagnosis and management of ureteral endometriosis is safe and efficient. Preoperative planning should be rigorous, and complete surgical excision of ureteral endometriosis should be ensured by a team of experts familiar with endometriosis, and its management.All patients who undergo laparoscopy for endometriosis should be evaluated for possible ureteral involvement regardless the presence or absence of urinary symptoms or prior radiological evaluation. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e756 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Oskar Kaufmann Sao Paulo, Brazil More articles by this author Heloisa Ferreira Brudniewski Sao Paulo, Brazil More articles by this author Winston Chen Sao Paulo, Brazil More articles by this author Rosa Maria Neme Sao Paulo, Brazil More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...