Approach to ureteral endometriosis: A single-center experience and meta-analysis of the literature.
J Obstet Gynaecol Res
; 49(1): 75-89, 2023 Jan.
Article
em En
| MEDLINE
| ID: mdl-36268633
ABSTRACT
AIM:
To report single-center outcomes of laparoscopic management of patients with ureteral endometriosis and perform a meta-analysis in order to select the best approach for these patients.METHODS:
The cross-sectional study was conducted during a 6-year period (2015-2021) in the referral endometriosis center on 353 patients with ureteral endometriosis. For the meta-analysis, 10 articles, including 505 patients, were found to be eligible. In our meta-analysis, as well as our study, all endometriosis-related pain symptoms and complications of surgery were evaluated, analyzed, and reported.RESULTS:
Of the 326 patients whose ureteral involvement was confirmed in pathology, hydronephrosis and intrinsic ureteral lesions were detected in only 10.76% and 3.1% of the patients. Mean operating time and hospitalization were 3.25 ± 1.83 h and 86 ± 2.58 days, respectively. The most common site of concomitant involvement with endometriosis was uterosacral ligament (92.9%) and rectosigmoid (70.53%). Type II and III of Cliven-Dindo complications were seen in 5.66% and 1.13% of patients, respectively. During a follow-up period, no evidence of bladder or ureteral re-involvement was observed. Similar to our meta-analysis, all endometriosis-related pain decreased significantly following operation (p ≤ 0.001). In our meta-analysis, the rate of ureteral endometriosis recurrence, stenosis/stricture, bladder atonia, urinary tract infection, hematuria, and fistula formation after surgery were 2.0% (I2 50.42%), 15.0% (I2 0.00%), 14.0% (I2 8.76%), 6.0% (I2 0.00%), 7.0% (I2 79.28%), and 2.0% (I2 0.0%), respectively.CONCLUSION:
The laparoscopic resection of the UE could be suggested as a feasible and safe method associated with favorable functional outcomes.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doenças Ureterais
/
Laparoscopia
/
Endometriose
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
/
Systematic_reviews
Limite:
Female
/
Humans
Idioma:
En
Revista:
J Obstet Gynaecol Res
Ano de publicação:
2023
Tipo de documento:
Article