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Surgery for endometriosis and ovarian remnant syndrome represents some of the most challenging and complex procedures faced by pelvic surgeons. Although infrequently encountered by medical specialists other than gynecologists, the procedures needed to extirpate a retained ovary or free the pelvis of endometriosis often require the coordinated efforts of gynecologic oncologists, urologists, and colorectal surgeons. This chapter focuses primarily on the pathology, etiology, diagnosis, and surgical management of these two challenging conditions.

The ureters are muscular tubes that convey urine from the renal pelvis to the bladder. They vary in length from 25 to 30 cm, depending upon the height of the person and the position of the kidneys. The left ureter is usually 1 cm longer than the right, size varying with the position of the kidney. Both ureters tend to be longer in males. Jewett found in a study of 100 newborn infants that only 16 had visible ureteropelvic junctions; and of 200 adults only 14% showed a well marked junction [14]. The majority of individuals had a funnel-type renal pelvis and ureter with no clear line of demarcation. Ureteral stenosis was most commonly found at the ureteropelvic junction.