Aims and objectives
Endometriosis is a pathology characterized by the presence of endometrial tissue (stroma and glands) in extrauterine sites; the sites most frequently affected by the endometriotic process are the ovaries,
the intestine,
the uterus-sacral ligaments,
the rectovaginal septum,
the ureter and the bladder.
The involvement of the urinary tract is rare and,
according to some authors,
is found in almost 1% of endometriosis; however its incidence is very variable.
The bladder is the most frequently involved organ,
followed by ureters and kidneys with a 40: 5:...
Methods and materials
STUDY POPULATION
In the period between February 2013 and January 2017,
in agreement with the Colleagues of Gynecology Department,
27 patients were selected who underwent MRI diagnostic investigation for deep pelvic endometriosis and subsequently underwent videlaparoscopic (VLS) therapeutic treatment.
The patients’ ages were distributed from a minimum of 26y to a maximum of 52y,
with an average of 35.85y.
The diagnosis of ureteral endometriosis was confirmed by histological examinations of the periureteral tissues and the nodules of endometriosis were surgically removed.
MRI TECHNIQUE
The MR...
Results
Of the 27 patients examined,
13 were positive for ureteral localization to VLS,
4 of which had bilateral localization,
thus representing a total of 17 lesions.
Only 1 patient showed intrinsic disease involvement,
while in the remaining 16 localizations only ureterolysis was performed,
due to extrinsic involvement (probably fibroaderential).
Of the 14 patients negative for ureteral localization,
6 patients had localizations at Douglas recess,
7 patients in the ovaries,
3 patients showed intestinal localizations,
2 patients in the utero-sacral ligaments,
1 patient showed bladder localization....
Conclusion
The ureteral localization of endometriotic process is a rather rare event,
reported in literature between 0.3% and 12%; in our experience,
it was calculated around 3.2% of patients with a positive history of endometriosis who performed diagnostic MR.
The diagnosis of this localization appears particularly difficult,
since it is difficult to find symptoms if not accompanied by hydronephrosis; moreover,
the absence of hydronephrosis makes the instrumental diagnosis particularly complex.
Therefore from our study we can state that for distances of less than 2 cm the...
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