Intrinsic endometriosis of ureter and bladder in young women without gynecological symptoms

Urological endometriosis as the primary and sole form of presentation is rare. With ultrasound being available at routine examinations by the urologist and gynecologist, asymptomatic and incidental hydronephrosis is picked up far more than before. The behavior of endometriosis may be very aggressive in terms of ingrowth and fibrosis of the ureter, the periureteral structures and the bladder. It is important to get to an accurate and timely diagnosis to prevent loss of renal function. We report 2 cases who presented with asymptomatic hydronephrosis. Because of severe ureteric obstruction and infiltration of the ureters and/or bladder, surgery was selected as treatment option. Ureteric stenting was not possible because of severe fibrosis and stricture formation of the distal ureter. Primary surgery gave satisfactory results at more than 1 year of follow-up.