输尿管子宫内膜异位症2例并文献复习

Ureteral endometriosis: report of 2 cases and literature review

目的探讨输尿管子宫内膜异位症的早期诊断与治疗方法。方法回顾分析2010年3月至2017年8月合肥市第三人民医院收治的2例输尿管子宫内膜异位症的临床资料,并结合文献进行总结探讨。结果 2例输尿管子宫内膜异位均位于输尿管下段,左侧1例,右侧1例。临床均表现为患侧腰部不适,影像学检查提示肾积水,输尿管扩张,患肾功能受损。2例均行输尿管镜扩张后效果不佳,再行开放手术输尿管狭窄段切除+端端吻合。术后输尿管恢复通畅,病理报告输尿管子宫内膜异位症。随访分别8年、6个月,未见复发。结论输尿管子宫内膜异位症发病隐匿,育龄期女性不明原因的输尿管狭窄应警惕此病。手术切除病灶+输尿管吻合效果确切。复杂性的子宫内膜异位症术后配合激素治疗可降低复发率。

Objective To explore the early diagnosis and treatment of ureteral endometriosis.Methods The clinical data of 2 cases of ureteral endometriosis admitted to Hefei Third People’s Hospital from March 2010 to August 2017 were analyzed retrospectively and discussed with literature.Results The 2 cases of ureteral endometriosis were located in the lower ureter,with one case on the left and one case on the right.The clinical manifestation was discomfort in the side waist,imaging findings suggested hydronephrosis,ureteral dilatation,suffering from impaired renal function.The results of ureteroscope dilatation were not effective in the 2 cases,and then the ureteral stricture was resected and the end-to-end anastomosis was performed.Postoperative patency of ureter was restored.Pathological report comfirmed ureteral endometriosis after orperation.Follow-up period was 6 months and 8 years,respectively,with no recurrence.Conclusion The pathogenesis of ureteral endometriosis is concealed,and it should be vigilant for women with unexplained ureteral stricture in childbearing age.Surgical resection of the lesion and ureter anastomosis was effective.Complicated endometriosis after operation with hormone therapy can reduce the recurrence rate.