Is the ureter usually looked at in a diagnostic laparoscopy?

[Jane884]

I have just been diagnosed with bladder endo, but urethral endo seems to fit one of my main symptoms (loin pain), and I'm wondering if my surgeon would have checked for it. I was still half out of it when she gave me my results and I'll have quite a wait to see a specialist. I had a surgery on my kidney and ureter (on the side where my endo happens to be worse) as a child, and I'm thinking endo may have stared growing at site of scar tissue.

[TennisAM]

Do you have 4 incisions? Did you say in advance about your history of urinary involvement?

If they're doing they're job properly, they should have looked but sadly sometimes they don't look everywhere.

[Jane884 in reply to TennisAM]

Thanks for your reply. I had 3 incisions. My consultant, who was aware of my previous urinary surgery was the one who carried out my lap. But she kept saying I had 2 previous c-sections when I've only had one, and had my symptoms wrong, I corrected her 4 times in my pre-op chat with her minutes before my surgery, so I wasn't instilled with confidence!

[TennisAM in reply to Jane884]

I see. I'd feel the same when speaking with a surgeon. It doesn't make you feel confident.

So, for comparison, I've had three surgeries, with two I had 4 incisions and the third, there were 5 incisions. I believe a thorough check means 4 incisions are created. Hopefully, two of the incisions are on the side where the ureter is that you have pain?

Have you got a urologist? If not, it's worth asking the GP to refer you urgently for advice. Hopefully you have an bsge endometriosis specialist centre nearby? Have you had a cystoscopy recently?

An ultrasound should show that the kidneys and ureter are safe (not blocked), but will not show if they're free moving.

[Jane884 in reply to TennisAM]

I had one incision through my belly button and then one either side of that.

Thank you so much for all the advice. I don't have a urologists, so I will ask for a referral. I've not a a cystoscopy since childhood, can that diagnose endometriosis of the urinary tract?

[TennisAM in reply to Jane884]

Hey, you're welcome. A cystoscopy will rule out any other obvious problems like cancer etc. In most cases if someone had urethra endo (on the inside) or bladder endo (on the inside) this should be seen too.

It cannot diagnose ureter endo unless a different test is done. Sorry can't remember the name, if you Google it, there's a way of looking into the ureters.

The external renal ultrasound would show if your kidneys are affected (they would he swollen) or if your ureter is blocked. If you have a situation like me, that the endo is on the outside of the ureter only, this won't show up on an ultrasound.

Urology told me the best way to see urinary involvement is a ct scan with contrast. But sadly Radiology refused because I've had a few CTs when I was younger and they worried about the radiation.

Hope you get to the bottom of all of this soon x

[Jane884 in reply to TennisAM]

I can't thank you enough for all of that information! You've just saved me a hell of a lot of reading!

My function is fine as of a few months ago, so I'm thinking endo on the exterior of the ureter is a possibility. I will ask for a CT scan with contrast, I have only had one before as a child. Is that something a GP can refer for, or will I need to wait to see my new specialist?

Thank you x

[TennisAM in reply to Jane884]

In theory I would say the GP can refer but I have no doubt the response will be "if we do, what will we do with it". Also the instructions as to what to request and who reviews it are very important. It needs to be a consultant Radiologist with Gynaecology Radiology training. If the hospital refers, then all this will generally be requested. Up to you x

[Jane884 in reply to TennisAM]

Thanks. The specialist I've been referred to is at a bsge centre, and I can see they have a urologist I'm the team, so maybe I'm just best to wait until I see the specialist there. Just trying to use the time in between to get ahead a bit, you know how long these things take x

[TennisAM in reply to Jane884]

Indeed. Definitely worth being referred to urology so you don't have to wait for the gynae team to do it xx