Ureteral endometriosis

Objective To evaluate the prevalence of ureteral endometriosis and to descr ibe the laparoscopic surgery. Design This is a prospective study. Results In a series of 306 patients with rectovaginal adenomyotic nodules, preoperative intravenous pyelography revealed ureteral stenosis with ureter ohydronephrosis in 14 cases (4.5%). In four patients, complete ureteral ste nosis was observed, and kidney scintigraphy revealed damaged kidney parench ymal function varying from 18% to 42%. Laparoscopic ureterolysis was possib le in 13 women, and a significant postoperative decrease in ureterohydronep hrosis was noted. In only one case, ureteral resection and uretero-ureteros tomy were needed. Conclusion In cases of rectovaginal adenomysois more than 3 cm, the prevale nce of ureteral endometriosis is high. The preoperative IVP is needed befor e laparoscopic ureterolysis which will avoid the silent loss of real functi on.