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Laparoscopic conservative management of ureteral endometriosis

Camanni, Marco; Delpiano, Elena M; Bonino, Luca; Deltetto, Francesco

Current Opinion in Obstetrics and Gynecology: August 2010 - Volume 22 - Issue 4 - p 309–314
doi: 10.1097/GCO.0b013e32833beacc
Minimally invasive gynecologic procedures: Edited by Colin J. Davis
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Purpose of review The surgical management of deeply infiltrating endometriosis involving the ureter is a complex procedure that requires an accurate balance between the need for complete excision of endometriotic foci and the need to avoid any morbidity associated with radical surgery. Owing to its rarity, a clear surgical strategy to deal with this condition (e.g. ureterolysis vs. ureteroneocystostomy) has not as yet been identified.

Recent findings A few studies present data about the conservative management of ureteral endometriosis. We reported the experience of some surgical topics dealing with ureteral endometriosis and their strategies for the conservative treatment of this condition.

Summary Ureterolysis could be used as the initial surgical step for patients with ureteral endometriosis. For patients displaying extended severe ureteral involvement, stenosis, or moderate or severe hydronephrosis with a high risk of having intrinsic ureteral disease, ureteroneocystostomy is likely to be a wiser surgical strategy. Moreover the crucial role of the primary surgeon in the treatment definition will hardly be replaced by objective reproducible referral pattern.

GINTEAM Unit of Minimally Invasive Gynaecology, Corso Marconi, Turin, Italy

Correspondence to Dr Marco Camanni, MD, Corso Marconi 35, 10125 Turin, Italy Tel: +39 03386568954; fax: +39 0116594547; e-mail: marcocamanni@tiscali.it

© 2010 Lippincott Williams & Wilkins, Inc.