title: [Indications and limits to endourologic procedures for endometriosis of the urinary tract].
abstract: BACKGROUND
  The incidence of Urinary tract endometriosis (UTE) ranges from 1% to 3%; bladder is the most affected organ (85% of UTE), followed by ureter (12 - 14% of UTE), for which we distinguish an intrinsic very rare form and an extrinsic variety most frequently occurring in advanced pelvic endometriosis.
  
  
  METHODS
  From 1997 to 2010, 33 surgical procedures for urologic endometriosis were performed, involving the urinary tract, in 28 patients with mean age of 31 years (25-43). The localization of endometriosis were: 7 cases in the bladder, 2 cases in the vesicoureteral tract, and 19 cases of ureteral tract only. Of these, two cases were diagnosed with an intrinsic localization.
  
  
  RESULTS
  Overall, we performed 3 TURB, 5 partial cystectomies (2 with open surgical approach and 3 by laparoscopy procedure), 12 laparoscopic ureterolysis and simultaneous protection of the upper urinary tract with stent, 9 cases of ureterocystoneostomy (UCNS) according to Lich-Gregoire procedure, and 3 according to Boari-Kuess procedure. Of the 12 patients who underwent ureterolysis with laparoscopic and stenting procedure, five cases required a UCNS according to Lich-Gregoire technique for persistent ureteral obstruction.
  
  
  CONCLUSIONS
  The limits of endoscopic procedures in endometriosis of the urinary tract are correlated both to the degree of extension and the localization of the disease. It is mandatory to achieve an interdisciplinary consensus in order to ensure the disease removal and the simultaneous functional results of the upper urinary tract.
authors.affiliation: SC Urologia, SC Anatomia Patologica ASL T0 5 Chieri (Torino), Italy. tanomarino@libero.it
authors.forename: G
authors.initials: G
authors.lastname: Marino
authors.forename: D
authors.initials: D
authors.lastname: Piras
authors.forename: M
authors.initials: M
authors.lastname: Pedalino
authors.forename: O G
authors.initials: OG
authors.lastname: Di Primio
authors.forename: R
authors.initials: R
authors.lastname: Vella
authors.forename: E
authors.initials: E
authors.lastname: Vercesi
mesh_terms: D000328:Adult; D015653:Cystectomy / Q000379:methods; D003559:Cystostomy / Q000379:methods; D004715:Endometriosis / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D010535:Laparoscopy; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D014515:Ureteral Diseases / Q000453:epidemiology / Q000601:surgery*; D014517:Ureteral Obstruction / Q000209:etiology / Q000601:surgery; D001745:Urinary Bladder Diseases / Q000453:epidemiology / Q000601:surgery*