Kaohsiung Journal of Medical Sciences
Volume 25, Issue 4 , Pages 217-221, April 2009

Endoscopic Management of A Ureteral Obstruction Caused by Endometriosis: A Case Report

  • Hsu-Cheng Juan

      Affiliations

    • Department of Urology, Kaohsiung Medical University;, Kaohsiung, Taiwan
    • ,
  • Hsin-Chih Yeh

      Affiliations

    • Department of Urology, Kaohsiung Medical University;, Kaohsiung, Taiwan
    • ,
  • Hsi-Lin Hsiao

      Affiliations

    • Department of Urology, Kaohsiung Medical University;, Kaohsiung, Taiwan
    • ,
  • Shean-Fang Yang

      Affiliations

    • Department of Pathology, Kaohsiung Medical University Hospital, Kaohsiung Medical University;, Kaohsiung, Taiwan
    • ,
  • Wen-Jeng Wu

      Affiliations

    • Department of Urology, Kaohsiung Medical University;, Kaohsiung, Taiwan
    • Department of Urology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
    • Corresponding Author InformationAddress correspondence and reprint requests to: Dr Wen-Jeng Wu, Department of Urology, Kaohsiung Medical University Hospital, 100 Tzyou 1st Road, Kaohsiung 807, Taiwan

Received 12 June 2008; accepted 25 September 2008.

Article Outline

Ureteral obstruction secondary to endometriosis is relatively uncommon. We present a 49-year-old female (gravida 3, para 2, abortion 1), who was identified as suffering from right hydronephrosis while undergoing her regular health examination. Retrograde pyelography demonstrated a partial obstruction of the right ureter in the distal third. She underwent ureteroscopy and biopsy to remove a right ureteral tumor. Histological examination confirmed ureteral endometriosis. During follow-up at the obstetrics and gynecology outpatient department, an abdominal echo was detected that revealed a right endometrioma (size, 7.5 × 4.8 × 5.5 cm) on the ovary. As a result, a total hysterectomy and bilateral salpingo-oophorectomy was performed. Although the patient had right residual hydronephrosis, the creatinine level improved to 1.2 mg/dL during follow-up.

Key Words:  endometriosis , hydronephrosis , ureter , ureteroscopy

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Takeuchi S , Minoura H , Toyoda N , et al.   Intrinsic ureteric involvement by endometriosis: a case report . J Obstet Gynaecol Res . 1997;23:273–276
  2. Vessey MP , Villard-Mackintosh L , Painter R . Epidemiology of endometriosis in women attending family planning clinics . BMJ . 1993;306:182–184
  3. Stillwell TJ , Kramer SA , Lee RA . Endometriosis of ureter . Urology . 1986;28:81–85
  4. Plous RH , Sunshine R , Goldman H , et al.   Ureteral endometriosis in post-menopausal women . Urology . 1985;26:408–411
  5. Metzger DA , Haney AF . Endometriosis: etiology and pathophysiology of infertility . Clin Obstet Gynecol . 1988;31:801–812
  6. Yuichi W , Hideo O , Katsutoshi U , et al.   Hydronephrosis due to ureteral endometriosis treated by transperitoneal laparoscopic ureterolysis . Int J Urology . 2004;11:560–562
  7. Zanetta G , Webb M , Segura JW . Ureteral endometriosis diagnosed at ureteroscopy . Obstet Gynecol . 1998;91:857–859
  8. Gantt PA , Hunt JB , McDonough PG . Progestin reversal of ureteral endometriosis . Obstet Gynecol . 1981;57:665–667
  9. Lavelle KJ , Melman AW , Cleary RE . Ureteral obstruction owing to endometriosis: reversal with synthetic progestin . J Urol . 1976;116:665–666
  10. Pittaway DE , Daniell JF , Maxson WS , et al.   Recurrence of ureteral obstruction caused by endometriosis after danazol therapy . Am J Obstet Gynecol . 1982;143:720–722
  11. Stebbing JF , Notely RG . Noncalculous obstruction due to involvement of the ureter in endometriosis . Eur Urol . 1995;28:122–125

PII: S1607-551X(09)70064-6

doi:10.1016/S1607-551X(09)70064-6

Kaohsiung Journal of Medical Sciences
Volume 25, Issue 4 , Pages 217-221, April 2009

Article Tools