AB120. Laparoscopic management of ureteral endometriosis with modified psoas hitch

Objective: To explore the feasibility of modified laparoscopic psoas hitch to treat ureteral endometriosis and evaluate its safety.

Methods: We respectively analyzed seven cases with pelvic deep invasive endometriosis which ureter was involved, who were hospitalized in department of gynecology between March 2012 and December 2013. The age was between 24 and 39 years old. The preoperative imaging showed that the left ureter was involved in five cases and the right ureter was involved in another two cases. The moderate or severe hydronephrosis was confirmed by MRI or CT scan. ECT showed moderate or severe damage of renal function. The distal involved ureter was removed with other involved organs and modified laparoscopic psoas hitch was performed to recover the urinary tract continuity in all seven cases.

Results: Modified laparoscopic psoas hitch was successfully performed in all seven cases without open conversion. The postoperative recovery was uneventful in six cases and discharged in 1-2 weeks postoperatively. A urethral catheter was dropped off postoperatively in one case and the ureterovesical anastomosis was broken. Open ureterovesical anastomosis was performed 3 months later and the patient was discharged in 3 weeks after the second operation.

Conclusions: Modified laparoscopic psoas hitch was proved a safe and feasible method to treat ureteral endometriosis in our small series. Long term follow-up is needed to evaluate its efficacy.

Keywords: Laparoscopy; ureteral endometriosis; modified psoas hitch