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| Name | A Dead End: Deep Endometriosis and Silent Kidney Death |
| Video Uploader | Video From CanSAGE Secretariat |
| Upload Date | This Video Uploaded At 13-11-2024 19:37:58 |
| Video Discription | This case presentation reviews the management of deep infiltrating endometriosis with ureteric involvement, highlighting the surgical approach to preserving kidney function and preventing "silent kidney death." Key steps include ureterolysis, nephrectomy for a non-functional kidney, and complete excision of endometriotic nodules. See full transcript here: www.cansagevideos.com/deep-endometriosis-silent-kidney-death Presented By Dr. Mariah Colussi Dr. Genevieve Horwood Dr. Hanan Alsalem Dr. Sukhbir Singh Affiliations The Ottawa Hospital; Minimally Invasive Gynecology Timestamps (00:11) Objectives (1:06) Case (01:56 - 06:18) Procedure Video (06:41) Summary Deep infiltrating endometriosis can severely impact surrounding organs, especially the ureters, leading to complications such as hydronephrosis and silent kidney failure. In this case, a 37-year-old woman with endometriosis and obstructed kidney function was found to have extensive endometriotic invasion causing bilateral ureteric compression, secondary hypertension, and a non-functional left kidney. The patient underwent a complex surgery involving nephrectomy of the non-functioning kidney, excision of the endometriotic nodules, and preservation of the remaining right ureter through ureterolysis. The surgical approach involved systematic dissection of pelvic and perirectal spaces, allowing for careful removal of disease while protecting the remaining kidney. Techniques such as uterine artery ligation and controlled dissection around the ureter helped ensure optimal resection with minimal risk to the patient's vital structures. This comprehensive resection aims to reduce disease recurrence and maintain function in the remaining kidney. In conclusion, advanced cases of deep endometriosis require proactive kidney assessment and a carefully planned surgical approach. This case underscores the importance of early diagnosis and intervention to prevent complications like silent kidney death, ensuring patients have the best chance for symptom relief and organ preservation. |
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