{"paper_id":"57b56262-78c4-45b6-b10b-0e5eb878a7a8","body_text":"Obstructive uropathy associated with primary ureteral endometrioma: case report and review of the literature\nDOI:\nhttps://doi.org/10.5489/cuaj.1098Abstract\nWe report the case of a 56-year-old postmenopausal woman who\npresented with incidental left hydronephrosis during an investigation\nfor a gastrointestinal complaint. The patient denied any history\nof flank pain or hematuria. Contrast-enhanced computed\ntomography revealed severe right-sided ureterohydronephrosis as\nwell as renal atrophy. The contralateral kidney was normal, as was\nthe patient’s overall renal function. A retrograde ureterogram\ndemonstrated complete ureteral obstruction 4 cm proximal to the\nureterovesical junction. Subsequent ureteroscopy revealed a polypoid\nmass completely occupying the ureteral lumen, of which the\nbiopsies demonstrated inconclusive atypical urothelial changes.\nThe patient underwent a laparoscopic nephrectomy with open\ndissection of the distal ureter. The patient recovered well postoperatively.\nFinal pathology revealed a benign obstructing\nendometrioma without evidence of invasion from periureteral\ntissue. This appears to be the first reported case of asymptomatic\nprimary ureteral endometrioma with secondary renal atrophy.\nEarlier investigation and treatment may have allowed for renal\npreservation earlier in the course of the disease.\nNous décrivons le cas d’une femme ménopausée de 56 ans présentant\nune hydronéphrose gauche découverte de façon fortuite au\ncours d’un examen mené pour donner suite à des symptômes gastro-\nintestinaux. La patiente n’avait pas d’antécédents de douleur\nau flanc ou d’hématurie. Une TDM avec agent de contraste a\nrévélé une urétéro-hydronéphrose droite importante accompagnée\nd’une atrophie rénale. Le rein controlatéral et la fonction rénale\nglobale de la patiente ne présentaient aucune anomalie. Une\nurétérographie par voie rétrograde a permis d’observer une obstruction\ncomplète de l’uretère proximale à 4 cm de la jonction urétérovésicale.\nUne urétéroscopie subséquente a révélé une masse polypoïde\noccupant la totalité de la lumière urétérale et des analyses\naprès biopsie ont montré des changements atypiques non concluants\nau niveau de l’épithélium urinaire. La patiente a subi une\nnéphrectomie par laparoscopie avec dissection ouverte de l’uretère\ndistale. La patiente s’est bien rétablie après l’intervention. Le\nrapport final de pathologie a révélé un endométriome obstructif\nbénin sans signe d’invasion des tissus péri-urétéraux. Il semble\nque ce soit ici le premier cas signalé d’endométriome urétéral\nprimitif asymptomatique avec atrophie rénale secondaire. Un examen\net un traitement réalisés plus tôt dans le cours de l’évolution\nde la maladie auraient pu permettre la préservation du rein.\nDownloads\nDownloads\nHow to Cite\nIssue\nSection\nLicense\nYou, the Author(s), assign your copyright in and to the Article to the Canadian Urological Association. This means that you may not, without the prior written permission of the CUA:\n- Post the Article on any Web site\n- Translate or authorize a translation of the Article\n- Copy or otherwise reproduce the Article, in any format, beyond what is permitted under Canadian copyright law, or authorize others to do so\n- Copy or otherwise reproduce portions of the Article, including tables and figures, beyond what is permitted under Canadian copyright law, or authorize others to do so.\nThe CUA encourages use for non-commercial educational purposes and will not unreasonably deny any such permission request.\nYou retain your moral rights in and to the Article. This means that the CUA may not assert its copyright in such a way that would negatively reflect on your reputation or your right to be associated with the Article.\nThe CUA also requires you to warrant the following:\n- That you are the Author(s) and sole owner(s), that the Article is original and unpublished and that you have not previously assigned copyright or granted a licence to any other third party;\n- That all individuals who have made a substantive contribution to the article are acknowledged;\n- That the Article does not infringe any proprietary right of any third party and that you have received the permissions necessary to include the work of others in the Article; and\n- That the Article does not libel or violate the privacy rights of any third party.","source_license":"CC0","license_restricted":false}