Yee David S, Shanberg Allan M, Ngo Anh T, Baghdassarian Ruben
Department of Urology, University of California, Irvine School of Medicine, 101 The City Drive, Bldg 26, Rm 24, Route 81, Orange, CA 92868, USA.
Int Urol Nephrol. 2006;38(3-4):469-71. doi: 10.1007/s11255-006-0101-7. Epub 2006 Nov 18.
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.
输尿管子宫内膜异位症是一种罕见疾病，通常为单侧发病。累及双侧输尿管的子宫内膜异位症以及激素治疗失败后的手术管理鲜有报道。我们描述了一名双侧输尿管子宫内膜异位症患者，该患者接受了双侧输尿管膀胱再植术及双侧输尿管腰大肌悬吊术。一名33岁患有晚期子宫内膜异位症和复发性肾盂肾炎的女性，被发现因输尿管子宫内膜异位症在盆腔入口处存在双侧重度输尿管梗阻。该患者随后接受了次全子宫切除术加双侧输卵管卵巢切除术、输尿管松解术、双侧输尿管膀胱再植术及腰大肌悬吊术和输尿管支架置入术。手术治疗适用于晚期疾病，最佳选择是输尿管再植术加腰大肌悬吊术。成功进行腰大肌悬吊输尿管再植术的关键手术要点是将膀胱完全向前和向外侧游离。
