Endoureterotomy is not a sufficient treatment for intrinsic ureteral endometriosis.

Abstract

AimTo investigate whether intrinsic ureteral endometriosis could be managed by laser endoureterotomy.Material and methodsWe studied retrospectively 6 patients with intrinsic ureteral endometriosis who underwent laser endoureterotomy and reviewed their clinical data. Pathological sections of them have also been studied by immunohistochemistry for expressional levels of oestrogen (ER) and progesterone (PR) receptors. Ten sections of normal endometrium were included as a control.ResultsFive patients had recurrence of ureteral stricture within 6 months postoperatively despite hormonal therapy for 3 to 6 months. One patient had recurrence 8 months after endoureterotomy. Two patients had secondary surgery for ureteroureterostomy and pathology confirmed recurrence of endometriosis. Immunohistochemistry revealed decreased ER and PR expression compared to the control.ConclusionsEndoureterotomy with hormonal therapy may not be suitable for ureteral endometriosis due to inadequate cutting and expressional change of ER and PR.

A pseudoneoplastic finding of deep endometriosis: laparoscopic triple segmental bowel resection.

“…This type of image seems to correspond to an infiltration of the whole muscularis in all cases and to an infiltration reaching the submucosa in 82% of cases [ 4 ]. Due to expressional decrease in both estrogen and progesterone receptors in the ectopic endometrium, the response to hormonal therapy may be compromised [ 5 ]. Moreover, endometriotic tissue in the bowel muscularis undergoes muscle cell hyperplasia and fibrosis, becoming resistant to medical treatment.…”