HCP Live
Contagion LiveCGT LiveNeurology LiveHCP LiveOncology LiveContemporary PediatricsContemporary OBGYNEndocrinology NetworkPractical CardiologyRheumatology Netowrk

Surgery risky for women with ureteral endometriosis symptoms

Dyspareunia, urinary functional symptoms, and dysmenorrhea were found in 47% of the women in the study.

For women with deep infiltrating endometriosis affecting the ureters, ureterovesical reimplantation surgery may provide some help. A small French study published in Journal of Gynecology Obstetrics and Human Reproduction looked at the long-term surgical outcomes as well as clinical and radiological symptoms.

Researchers retrospectively looked at women with endometriosis who underwent ureterovesical reimplantation at Lille hospital from 2003 at 2013. A total of 17 patients were included with 29% having a history of urologic surgery and 53% had urological symptoms of endometriosis. The average delay between the diagnosis of endometriosis and the ureteral reimplantation surgery was 64 ±65 months.

Urinary functional symptoms, mainly presenting as lower back pain, were seen in 47% of patients. In 82% of the cases, the ureteral lesion was known preoperatively and linked with hydroureteronephrosis. Renal function was impaired in 23% of the cases and 35% of the women had renal atrophy. Patients were followed-up for 45 ±27 months. Following the surgery, 41% of patients had at least 1 immediate nerve compression, postoperative complication-fistula, or postoperative infection. Dyspareunia, urinary functional symptoms, and dysmenorrhea were found in 47% of the women.

The researchers stressed that ureterovesical implantation is a major surgery and women with endometriosis frequently develop complications from it. Reducing risks requires close collaboration among urologists, radiologists, and gynecologists. When preparing for the procedure, a comprehensive collection of patient information is a necessity.

 

Chudzinski A, Collinet P, Flamand V, Rubod C. Ureterovesical reimplantation for ureteral deep infiltrating endometriosis: A retrospective study.  Gynecol Obstet Hum Reprod. 2017;46(3):229-233.