title: [Diagnosis and treatment of ureter endometriosis].
abstract: OBJECTIVE
  To investigate strategies of diagnosis and treatment of ureter endometriosis.
  
  
  METHODS
  From 1983 to 2010, the cases registered in Peking Union Medical College Hospital and confirmed as ureter endometriosis by surgery were enrolled in this study. Clinical manifestations, pre-operative examinations, surgical categories and routes, surgical and pathological findings, post-operative medical treatment, relapse and relating factors were collected and studied.
  
  
  RESULTS
  Totally 46 patients with ureter endometriosis underwent one or two surgeries. Forty-eight per cent (22/46) of patients were not be diagnosed with ureter endometriosis pre-operatively, and 46% (21/46) only presented dysmenorrhea or even no symptoms. Ureterolysis (72%, 33/46) and laparotomy (63%, 29/46) were the most common surgical category and surgical approach. There were 64% (25/39) of patients had left ureter involved and 80% (37/46) had extrinsic ureter endometriosis. Fifteen per cent (7/46) of patients had relapsed disease with median recurrent time of 24 months (13-49 months), and they all received second surgeries. Logistic regression analysis showed that only gonadotropin releasing hormone analogue agents were related with recurrence when compared with those patients without medical treatment post-operatively significantly (OR=23.2, 95%CI: 2.4-221.7, P=0.002).
  
  
  CONCLUSIONS
  Ureter endometriosis was related with reproductive tract endometriosis. It has insidious process resulting in difficulty for early diagnosis. It's important to treat pelvic deep infiltrating endometriosis and ovarian endometrioma to prevent ureter from further involvement. Post-operative treatment of pelvic endometriosis is the key point of preventing relapse of ureter endometriosis.
authors: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
authors: Lei
authors: L
authors: Li
authors: Jin-hua
authors: JH
authors: Leng
authors: Jing-he
authors: JH
authors: Lang
authors: Zhu-feng
authors: ZF
authors: Liu
authors: Da-wei
authors: DW
authors: Sun
authors: Lan
authors: L
authors: Zhu
authors: Qing-bo
authors: QB
authors: Fan
authors: Jing-hua
authors: JH
authors: Shi