Original ArticleImportance of Retroperitoneal Ureteric Evaluation in Cases of Deep Infiltrating Endometriosis
Section snippets
Study Population
Between June 2002 and June 2006, a continuous series of 541 patients underwent laparoscopic treatment for pelvic endometriosis in a tertiary referral center for treatment of endometriosis. For all of these patients, medical, gynecologic, and operative records were retrospectively reviewed by 2 authors (R. S., M. M.) and assessed to identify cases with ureteral endometriosis. Diagnosis was done after laparoscopic, retroperitoneal isolation, examination of the diameter and consistency of both
Results
Of the 541 patients eligible for the study, 30 patients with surgical diagnosis and histologic confirmation of ureteral endometriosis were included in the study population. Clinical characteristics of the patients recruited are reported in Table 1.
Discussion
Although ureteral endometriosis is not a frequent disease, it can be considered one of the most serious symptoms of endometriosis that carries high risk of morbidity including loss of renal function [11].
Timely management of ureteral endometriosis is a real challenge not only because of the nonspecific or silent symptoms, but also because of the lack of sensitive diagnostic tools that can detect early involvement. Early suspicion of ureteral endometriosis is fundamental to avoid impairment of
Conclusions
Ureteral endometriosis is a silent, serious disease that carries the risk of renal function loss. Preoperative diagnosis of this condition is really challenging and needs a high index of suspicion. As DIE is a global disease and lesions are multifocal and a large percentage of cases, we strongly recommend that patients with DIE should be referred to specialized centers and the surgical team must have consistent background in laparoscopic management of DIE. We also recommend that all cases of
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