Surgical management of bilateral ureteral endometriosis.
Ureteral endometriosis is a rare disease that typically is unilateral. Endometriosis involving both ureters and surgical management after hormone therapy failure has seldom been described. We describe a patient with bilateral ureteral endometriosis who underwent ureteroneocystostomy with psoas hitches of both ureters. A 33-year-old woman with advanced endometriosis and recurrent pyelonephritis was found to have high-grade bilateral ureteral obstruction at the pelvic inlet from ureteral endometriosis. The patient subsequently underwent a supracervical hysterectomy with bilateral salpingo-oophorectomy, ureterolysis, and ureteroneocystostomy with psoas hitches and ureteral stent placements. Surgical therapy is reserved for advanced disease with the optimal choice being a ureteral reimplantation with a psoas hitch. The key operative point for a successful psoas hitch ureteral reimplantation is completely mobilizing the bladder anteriorly and laterally.
Yee
David S
DS
Department of Urology, University of California, Irvine School of Medicine, 101 The City Drive, Bldg 26, Rm 24, Route 81, Orange, CA 92868, USA. dyee@uci.edu
Shanberg
Allan M
AM
Ngo
Anh T
AT
Baghdassarian
Ruben
R
D000328:Adult; D004715:Endometriosis / Q000601:surgery*; D005260:Female; D006801:Humans; D014515:Ureteral Diseases / Q000601:surgery*