外科手术治疗输尿管子宫内膜异位症的临床疗效分析

Analysis of clinical therapeutic effect of ureteral endometriosis treated with surgical procedures.

目的分析外科手术治疗输尿管子宫内膜异位症的临床治疗效果。方法回顾分析2002～2011年病理证实的经外科手术治疗的输尿管子宫内膜异位症患者的临床治疗资料。结果 23例患者中3例行输尿管粘连松解术;6例行输尿管狭窄段切除,输尿管膀胱再吻合术;12例行输尿管狭窄段切除,输尿管端端吻合术;2例行输尿管镜下子宫内膜异位病损电切术。术后病理均为子宫内膜异位症。术后随访,未见复发病例。随访的20例患者术后复查超声、静脉肾盂造影检查,提示肾积水有不同程度的好转。结论输尿管子宫内膜异位症临床少见。经外科手术治疗的输尿管子宫内膜异位症的临床疗效令人满意。输尿管粘连松解术治疗轻度输尿管梗阻患者与输尿管狭窄段切除术治疗中重度输尿管梗阻患者的治疗方案均值得推荐。

Objective To evaluate the clinic therapeutic effect of surgical procedures for ureteral endometriosis.Methods A retrospective analysis of 23 ureteral endometriosis cases treated with surgical procedures with histopathological results from 2002 to 2011 was performed.Results All the 23 patients with ureteral endometriosis underwent surgical procedures.The surgical procedures consisted of ureterolysis in 3 cases,distal ureterectomy and ureterocystoneostomy in 6,partial ureteral resection and end-to-end ureteral anastomosis in 12,and endoscopic resection of ureteral endometriosis lesion in 2.All the patients pathologic results were of endometriosis.In the follow-up period,no relapse cases was found.Through the medical imaging examination（ultrasound examination and intravenous pyelogram）,there were different degrees of improvement in their hydronephrosis.Conclusion Ureteral endometriosis is an uncommom disease.The clinic therapeutic effect of ureteral endometriosis treated with surgical procedures is satisfactory.It is recommendable to underwent ureterolysis for cases with mild ureteral obstruction and partial ureteral resection for those with moderate and severe ureteral obstruction.