目的 探讨治疗输尿管子宫内膜异位症的手术方式.方法 回顾分析2002～ 2011年病理证实的23例输尿管子宫内膜异位症患者的临床诊治资料.结果 23例患者中,3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例行输尿管镜下病损电切术.术后病理诊断均为子宫内膜异位症.8例接受了术后激素辅助治疗.术后随访成功的20例患者均未出现复发.结论 输尿管子宫内膜异位症是一种临床少见的疾病.对于伴有肾积水的患者,治疗上以手术治疗为主,内分泌治疗为辅.对于轻度的输尿管梗阻患者,推荐行输尿管粘连松解术治疗；对于中重度输尿管梗阻患者,推荐行输尿管狭窄段切除的手术治疗.%Objective To discuss the appropriate choice of different surgical procedures for ureteral endometriosis. Methods We performed a retrospective analysis of 23 cases of ureteral endometriosis with histopathological results from 2002 to 2011. Results In these cases, the treatments consisted of ureterolysis in 3 cases, 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. Adjuvant hormonal therapy was applied to 8 postoperative cases. For the 20 cases with follow-up, no recurrence was found. Conclusions Ureteral endometriosis is an uncommom disease. For patients of ureteral endometriosis with hydronephrosis, surgical procedures should be accepted as the first clinical therapeutic choice, whilst hormonal therapy as an adjuvant management. For patients with mild ureteral obstruction, the recommended management is ureterolysis; while for those with moderate and severe ureteral obstruction, the recommended procedure is partial ureteral resection.
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