Management of ureteral endometriosis with hydronephrosis: Experience from a tertiary medical center
Management of ureteral endometriosis with hydronephrosis: Experience from a tertiary medical center
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DOI：
10.1111/jog.13422
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发表时间：
2017-10-01
影响因子：
1.6
通讯作者：
Chen, Shu-Qin
中科院分区：
文献类型：
--
作者：
Huang, Jing-Zhi;Guo, Hong-Ling;Chen, Shu-Qin
目的：报告输尿管子宫内膜异位症的临床特点和手术治疗经验。方法：回顾分析输尿管子宫内膜异位症致肾积水患者的临床资料。结果：46例患者均有不同程度的肾积水，35%有尿路症状。超过三分之二的患者同时受累于同侧卵巢。4例行肾切除术，其中1例6个月后因肾积水复发致输尿管松解。结论：肾积水可能是由罕见原因引起的，如输尿管子宫内膜异位症，甚至可导致无症状的肾功能丧失。对于严重的子宫内膜异位症患者，常规的上尿路超声扫描对于发现任何潜在的输尿管病变是非常重要的。应考虑将输尿管松解术作为手术的第一步，这不仅是为了避免医源性输尿管损伤，也是为了更好地评估输尿管受累情况，以便进行进一步的手术。为了保证无张力和无损伤的吻合术，明智的做法是进行输尿管膀胱吻合术以获得长期良好的结果。
Aim: We report the clinical characteristics and experience of the surgical management of ureteral endometriosis in our institution.Methods: We retrospectively reviewed the data of patients with hydronephrosis resulting from ureteral endometriosis.Results: Forty-six patients with different degrees of hydronephrosis were included in the study; 35% had urinary tract symptoms. Concomitant involvement of the ipsilateral ovary occurred in more than two-thirds of the patients. Four patients had nephrectomy, one of which involved ureterolysis because of hydronephrosis recurrence six months later.Conclusions: Hydronephrosis may be caused by uncommon reasons, such as ureteral endometriosis, which can even cause silent loss of renal function. Routine ultrasound scanning of the upper urinary tract for severe stages of endometriosis is very important in order to detect any potential ureteral lesions. Ureterolysis should be considered as the first surgical step, not only to avoid iatrogenic ureteral injuries but also to better evaluate ureter involvement for further procedures. To warrant tension-free and lesion-free anastomosis, it is wise to perform ureteroneocystostomy for long-term sound results.