Ureteral endometriosis and coexistent urethral leiomyoma in a postmenopausal woman

<!-- Brazil - Ureteral endometriosis and coexistent urethral leiomyoma in a postmenopausal woman Ureteral endometriosis and coexistent urethral leiomyoma in a postmenopausal woman window.dataLayer = window.dataLayer || []; function gtag(){dataLayer.push(arguments);} gtag('js', new Date()); gtag('config', 'G-MKLVK7B5B6'); .articleTxt{ top: -16px; } .scielo__border-top{ border-top: 1px solid #ccc !important; } @media (max-width: 575.98px) { .articleCtt > .container{ padding-left: 0; padding-right: 0; } .articleCtt .articleTxt{ padding-left: 16px !important; padding-right: 16px !important; } } @media (min-width: 768px){ .scielo__truncate{ display: block; max-width: 285px; } } menu Menu Brazil Journal list by title Journal list by subject area Search Metrics (abre em nova aba) Sobre o SciELO Brazil Contacts Report error SciELO.org - The SciELO Network (abre em nova aba) National and thematic collections (abre em nova aba) Journal list by title (abre em nova aba) Journal list by subject (abre em nova aba) Search (abre em nova aba) Metrics (abre em nova aba) OAI and RSS (abre em nova aba) About the SciELO Network (abre em nova aba) Contacts (abre em nova aba) Blog SciELO in Perspective (abre em nova aba) document.addEventListener('DOMContentLoaded', function () { const wrapper = document.getElementById('scieloMainMenu'); const toggle = document.getElementById('scieloMainMenuToggle'); const panel = document.getElementById('scieloMainMenuNav2'); if (!wrapper || !toggle || !panel) return; const icon = toggle.querySelector('.material-icons-outlined'); const focusableSelector = [ 'a[href]', 'button:not([disabled])', 'input:not([disabled])', 'select:not([disabled])', 'textarea:not([disabled])', '[tabindex]:not([tabindex="-1"])' ].join(','); function setIcon(iconName) { if (icon) { icon.textContent = iconName; } } function getFocusableItems() { return Array.prototype.slice.call(panel.querySelectorAll(focusableSelector)) .filter(function (item) { return item.offsetParent !== null; }); } function openMenu() { panel.hidden = false; toggle.setAttribute('aria-expanded', 'true'); wrapper.classList.add('is-open'); setIcon('close'); const focusableItems = getFocusableItems(); if (focusableItems.length) { focusableItems[0].focus(); } } function closeMenu(options) { const settings = options || {}; panel.hidden = true; toggle.setAttribute('aria-expanded', 'false'); wrapper.classList.remove('is-open'); setIcon('menu'); if (settings.restoreFocus) { toggle.focus(); } } function isMenuOpen() { return toggle.getAttribute('aria-expanded') === 'true'; } toggle.addEventListener('click', function (event) { event.preventDefault(); event.stopPropagation(); if (isMenuOpen()) { closeMenu({ restoreFocus: true }); } else { openMenu(); } }); panel.addEventListener('click', function (event) { event.stopPropagation(); }); document.addEventListener('click', function (event) { if (isMenuOpen() && !wrapper.contains(event.target)) { closeMenu(); } }); document.addEventListener('keydown', function (event) { if (!isMenuOpen()) return; if (event.key === 'Escape') { event.preventDefault(); closeMenu({ restoreFocus: true }); return; } if (event.key !== 'Tab') return; const focusableItems = getFocusableItems(); if (!focusableItems.length) return; const firstItem = focusableItems[0]; const lastItem = focusableItems[focusableItems.length - 1]; if (event.shiftKey && document.activeElement === firstItem) { event.preventDefault(); toggle.focus(); return; } if (!event.shiftKey && document.activeElement === toggle) { event.preventDefault(); firstItem.focus(); return; } if (!event.shiftKey && document.activeElement === lastItem) { closeMenu(); } }); }); Brazil language en English Português Español International braz j urol Mostrar opções launch Submission of manuscripts info About the journal help_outline Política editorial people Editorial Board help_outline Instructions to authors email Contact show_chart Metrics home Table of contents navigate_before previous current next navigate_next Text (EN) Text (English) PDF Download PDF (English) article Conteúdo: Text (EN) Text (English) Download PDF (English) (abre em nova aba) share Whatsapp BlueSky Mastodon Facebook Mais home Table of contents share Whatsapp BlueSky Mastodon Facebook Mais Text (EN) Text (English) PDF Download PDF (English) (abre em nova aba) Case Report • Int. braz j urol. 30 (6) • Dec 2004 • https://doi.org/10.1590/S1677-55382004000600008 link copy Ureteral endometriosis and coexistent urethral leiomyoma in a postmenopausal woman Authorship SCIMAGO INSTITUTIONS RANKINGS Abstract We report the case of a postmenopausal woman with a synchronous obstructing intrinsic endometrioma of the left ureter and a coexistent periurethral leiomyoma. Endometriosis in postmenopausal women is a rare clinical entity usually associated with exogenous estrogen use. Urethral leiomyomas are also rare, with only 40 cases reported in the literature. Ovarian hormones are believed to influence the growth of leiomyomas. We report the genitourinary presentation of 2 separate disease entities with known hormonal influence in a postmenopausal woman receiving estrogen replacement therapy. We believe the patient's hormonal milieu affected the development of her concurrent pathology. ureter; urethra; leiomyoma; endometriosis CASE REPORT Ureteral endometriosis and coexistent urethral leiomyoma in a postmenopausal woman Andrew Strang; Scott W. Lisson; Steven P. Petrou Wake Forest School of Medicine, Winston Salem, North Carolina, and Department of Urology, Mayo Clinic, Jacksonville, Florida, USA Correspondence ABSTRACT We report the case of a postmenopausal woman with a synchronous obstructing intrinsic endometrioma of the left ureter and a coexistent periurethral leiomyoma. Endometriosis in postmenopausal women is a rare clinical entity usually associated with exogenous estrogen use. Urethral leiomyomas are also rare, with only 40 cases reported in the literature. Ovarian hormones are believed to influence the growth of leiomyomas. We report the genitourinary presentation of 2 separate disease entities with known hormonal influence in a postmenopausal woman receiving estrogen replacement therapy. We believe the patient's hormonal milieu affected the development of her concurrent pathology. Key words: ureter; urethra; leiomyoma; endometriosis INTRODUCTION Endometriosis occurs rarely in postmenopausal women and is usually associated with exogenous estrogen use or excessive endogenous production by the adrenals or pituitary gland (1). Leiomyomas are benign tumors of smooth muscle origin and are infrequently found in the urinary tract, with only 40 cases of urethral leiomyoma reported in the literature (2,3). The growth of both endometriomas and leiomyomas may be hormonally related. We report the case of a postmenopausal woman with a synchronous obstructing intrinsic endometrioma of the left ureter and a coexistent periurethral leiomyoma. CASE REPORT A 65-year-old woman was evaluated for painless gross hematuria. She denied irritative voiding symptoms or a history of urolithiasis or urinary tract infections. The patient's medications included conjugated estrogens and ramipril. Pelvic examination indicated a thickened urethra. Her laboratory test results were unremarkable. The patient had normal cystoscopic findings, and intravenous pyelography (IVP) revealed poorly opacified, dilated calices throughout the left intrarenal collecting system without visualization of the left distal ureter. Computed tomography (CT) noted a high-density mass within the left distal ureter. Ureteroscopic biopsy of the ureteral mass ( Figure-1 ) indicated endometriosis. Magnetic resonance imaging of the urethra noted a 2.9X2.9X3 cm posterior periurethral mass ( Figure-2 ) with signal characteristics suggestive of a leiomyoma. The patient underwent pelvic exploratory surgery with left pelvic lymphadenectomy, left distal ureterectomy and ureteroneocystostomy. The periurethral lesion was transvaginally excised. Pathologic analysis confirmed a benign leiomyoma. COMMENTS Endometriosis in postmenopausal women is a rarity usually associated with exogenous estrogen use or excessive endogenous production by the adrenals or pituitary gland (1). Endometriosis involving the genitourinary tract has been reported with an incidence of 1.2% and a mean age between 30 and 35 years (1). The ratio of occurrence in the bladder to ureter to urethra is 40:5:1 (1). On IVP, intrinsic endometriomas tend to produce filling defects and may mimic transitional cell carcinoma and radiolucent stones. Intrinsic lesions represent advanced disease and require resection of the involved segment. Leiomyomas are benign tumors of smooth muscle origin found rarely in the urinary tract, with 40 cases reported in the literature (2,3). Leiomyomas are 3 times more common in women with an average age at presentation of 39 years (3). Common presenting symptoms include urinary tract infection, mass effect, voiding dysfunction, and dyspareunia. The most common site of urethral occurrence is the posterior wall (3). Excision is the treatment of choice. Ovarian hormones are believed to influence the growth of leiomyomas (2). The incidence of these benign tumors increases after menarche. Estrogen and progesterone receptors have been demonstrated in uterine smooth muscle tumors and underscore the rationale for medical treatment of these lesions (3). Endometriomas are also hormone-sensitive lesions with their growth likely affected by ovarian steroids. Like leiomyoma, endometriosis is treated medically with hormonal agents aimed at suppressing the hypothalamic-pituitary-gonadal production of gonadotropins. We report the genitourinary presentation of 2 separate disease entities with known hormonal influence in a postmenopausal woman receiving estrogen replacement therapy. We entertain the likelihood that the patient's hormonal milieu affected the development of her concurrent pathology. Received: July 12, 2004 Accepted: August 13, 2004 References 1. Yohannes P: Ureteral endometriosis. J Urol. 2003; 170: 20-5. 2. Alvarado-Cabrero I, Candanedo-Gonzalez F, Sosa-Romero A: Leiomyoma of the urethra in a Mexican woman: a rare neoplasm associated with the expression of estrogen receptors by immunohistochemistry. Arch Med Res. 2001; 32: 88-90. 3. Kurokawa S, Kojima Y, Tozawa K, Hayashi Y, Sasaki S, Kohri K: Female paraurethral leiomyoma: immunohistochemical approach to the relationship between leiomyoma and ovarian hormones. J Urol. 2002; 167: 1403-4. Correspondence to Dr. Steven P. Petrou Department of Urology, Mayo Clinic 4500 San Pablo Road Jacksonville, Florida, 32224, USA Phone: + 1 904 953-0413 E-mail: [email protected] Publication Dates Publication in this collection 08 Mar 2005 Date of issue Dec 2004 History Received 12 July 2004 Accepted 13 Aug 2004 This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. Authorship .author-card { border-bottom: 1px solid #ccc; padding: 1rem 0; } .author-card:last-child { border-bottom: 0px; } .author-name { font-weight: 600; } .orcid-button { padding-left: 2.5rem; } .modal-body { padding-bottom: 3rem; } .orcid-button::before { content: ""; position: absolute; background-image: url(https://ds.scielo.org/img/logo-orcid.svg); background-repeat: no-repeat; background-size: 1.5em auto; background-position: .5em center; display: block; width: 60px; height: 60px; top: -10px; left: 0; } person Andrew Strang school Wake Forest School of Medicine, Winston Salem, North Carolina Wake Forest School of Medicine Winston Salem, North Carolina Wake Forest School of Medicine, Winston Salem, North Carolina school Mayo Clinic, Department of Urology , Jacksonville, , United States Mayo Clinic United States Jacksonville, , United States Mayo Clinic, Department of Urology , Jacksonville, , United States person Scott W. Lisson school Wake Forest School of Medicine, Winston Salem, North Carolina Wake Forest School of Medicine Winston Salem, North Carolina Wake Forest School of Medicine, Winston Salem, North Carolina school Mayo Clinic, Department of Urology , Jacksonville, , United States Mayo Clinic United States Jacksonville, , United States Mayo Clinic, Department of Urology , Jacksonville, , United States person Steven P. Petrou school Wake Forest School of Medicine, Winston Salem, North Carolina Wake Forest School of Medicine Winston Salem, North Carolina Wake Forest School of Medicine, Winston Salem, North Carolina school Mayo Clinic, Department of Urology , Jacksonville, , United States Mayo Clinic United States Jacksonville, , United States Mayo Clinic, Department of Urology , Jacksonville, , United States SCIMAGO INSTITUTIONS RANKINGS Mayo Clinic, Department of Urology , Jacksonville, , United States Mayo Clinic United States Jacksonville, , United States Mayo Clinic, Department of Urology , Jacksonville, , United States Wake Forest School of Medicine, Winston Salem, North Carolina Wake Forest School of Medicine Winston Salem, North Carolina Wake Forest School of Medicine, Winston Salem, North Carolina Figures Figures (2) Thumbnail Thumbnail image open_in_new image open_in_new How to cite link copy function currentDate() { var today = new Date(); var months = ['January', 'February', 'March', 'April', 'May', 'June', 'July', 'August', 'September', 'October', 'November', 'December'] today.setTime(today.getTime()); return today.getDate() + " " + months[today.getMonth()] + " " + today.getFullYear(); } var citation = 'Strang, Andrew, Lisson, Scott W. and Petrou, Steven P.. Ureteral endometriosis and coexistent urethral leiomyoma in a postmenopausal woman. International braz j urol [online]. 2004, v. 30, n. 6 [Accessed CURRENTDATE], pp. 496-498. Available from: . Epub 08 Mar 2005. ISSN 1677-6119. https://doi.org/10.1590/S1677-55382004000600008.'.replace('CURRENTDATE', currentDate()); document.getElementById('citation').innerHTML = citation; document.getElementById('citationCut').value = citation.replace('<', ' "); more_horiz Ferramentas do artigo file_download PDFs show_chart Metrics image Figuras e tabelas translate Versions and translations link How to cite this article article Related articles location_on Sociedade Brasileira de Urologia Rua Bambina, 153, 22251-050 Rio de Janeiro RJ Brazil, Tel. +55 21 2539-6787, Fax: +55 21 2246-4088 - Rio de Janeiro - RJ - Brazil E-mail: [email protected] rss_feed Stay informed of issues for this journal through your RSS reader PDF version for download PDF English Related articles Lista de links para artigos relacionados. Os links abrem em nova aba. Google (abre em nova aba) Google Scholar (abre em nova aba) Versões e tradução automática Escolha a versão original do texto ou utilize um serviço de tradução automática. Versão original do texto English Tradução automática Google Translator (abre serviço externo de tradução) Microsoft Translator (abre serviço externo de tradução) pre { display: block; padding: 9.5px; margin: 0 0 10px; font-size: 11px; line-height: 1; word-break: break-all; word-wrap: break-word; background-color: #f5f5f5; border: 1px solid #ccc; border-radius: 4px; white-space: pre-wrap; word-break: break-word; } Como citar Escolha um formato para exportar ou selecione um estilo de citação. O conteúdo abaixo pode ser atualizado após a seleção. Baixar em RIS Baixar em BIBTEX Outros formatos de citação e exportação: Enter references manager format or citation style (e.g., "APA", "AMA", "MLA", "Vancouver") vertical_align_top Go to top // Mostrar o botão ao rolar const btnTop = document.getElementById("btnTop"); window.addEventListener("scroll", () => { if (window.scrollY > 200) { btnTop.style.display = "block"; } else { btnTop.style.display = "none"; } }); // Rolar suavemente até o topo ao clicar btnTop.addEventListener("click", () => { window.scrollTo({ top: 0, behavior: "smooth" }); }); .scielo__logo-partner{ max-height: 50px; max-width: 170px; } .scielo__logo-partner--dark{ display:none; } .scielo__theme--dark .scielo__logo-partner--light{ display:none; } .scielo__theme--dark .scielo__logo-partner--dark{ display:inline-block; } Brazil Rua Dr. Diogo de Faria, 1087 – 9º andar – Vila Clementino 04037-003 São Paulo/SP - Brasil E-mail: [email protected] Read our Open Access Statement Metrics SciELO Analytics Dimensions Altmetric Scite_ Ureteral endometriosis and coexistent urethral leiomyoma in a postmenopausal woman PlumX × Close Message × Close Message Report error // Variáveis para tradução da barra de acessibilidade window.accessibilityTranslations = { darkMode: "Dark mode", increaseText: "Increase text", decreaseText: "Decrease text", originalText: "Original text", markerLine: "Marker", readingLine: "Guide line", reset: "Reset", accessibilityMenu: "Accessibility menu", skipLinkText: "Ir para o conteúdo principal" }; $(document).ready(function() { // Add rows article search let addRowBtn = $('.addRowBtn'); let placeRow = $('.scielo__dinamic-row'); let newFormRow = ' clear AND OR AND NOT All indexes Year Author Funder Journal Abstract Title '; let btnRemoveRow = $('.btn-danger'); addRowBtn.on( "click", function() { placeRow.append( newFormRow ); }) // Remove as linhas inseridas dinamicamente e as que já estavam lá. placeRow.on( "click", ".btn-danger", function() { $(this).parent().parent().animate({'opacity':0},300).hide(1); }) }); <!-- var insertScript = function(url, callback, parentNode) { var scriptNode = document.createElement("script"); scriptNode.src = url; scriptNode.onload = callback; parentNode.appendChild(scriptNode) } var headNode = document.getElementsByTagName("head")[0]; setTimeout(MathJax.Callback([insertScript, "//badge.dimensions.ai/badge.js", console.log, headNode]), 1500); --> affiliations = {}; function add_scimago_image(selector, remove_br=true, add_br_after=true, find_div=false){ $(selector).each( function () { if (remove_br){ $(this).find("br").remove() } internal_items = find_div ? $(this).find('div').not(".clearfix") : $(this).not(".clearfix") internal_items.each(function () { self = $(this); affiliation_name = $('span:first', self).text(); if (affiliation_name){ scimago_link = ' '; self.append(scimago_link); } }); if (add_br_after){ $(this).after(" ") } }); } add_scimago_image('#ModalScimago .info div') add_scimago_image('.tutors', remove_br=false, add_br_after=false, find_div=true) $(".scimago_link").click(function(e){ e.preventDefault(); affiliation_name = $(this).data("affiliation"); if (affiliation_name){ if (affiliations[affiliation_name]) { window.open(affiliations[affiliation_name], '_blank'); } else { $.ajax({ type: "GET", async: false, url: "/scimago/query", data: 'q=' + encodeURI(affiliation_name), success: function (data) { if (data) { affiliations[affiliation_name] = 'https://www.scimagoir.com/' + data window.open(affiliations[affiliation_name], '_blank'); }else{ toastr.options = { positionClass: 'toast-top-center' }; toastr.error('Link temporariamente indisponível'); } } }); } } }); var howcite_initialized = false; $('#ModalHowcite').on('shown.bs.modal', function () { if (!howcite_initialized) { initial = { "American Psychological Association": "apa", "Vancouver": "vancouver" } $.each(initial, function (key, value) { $.ajax({ url: "/citation/DTV4K7PGcQVwrr9ZfcRD4Kx/?style=" + value, dataType: 'html', delay: 250, async: true }) .done(function (html) { $(" " + key + " " + " " + html + " ").insertBefore($("#select_label")); }) }); howcite_initialized = true; } $(".js-data-example-ajax").select2({ ajax: { url: "/citation/list", dataType: 'json', delay: 250, data: function (params) { return { q: params.term, // search term }; }, processResults: function (data, params) { return { results: data.results }; }, cache: true }, escapeMarkup: function (markup) { return markup; }, minimumInputLength: 1, dropdownParent: $('#ModalHowcite') }); $(document).on('select2:open', () => { document.querySelector('.select2-search__field').focus(); }); $(".js-data-example-ajax").on('select2:select', function (e) { var data = e.params.data; $.ajax({ url: "/citation/DTV4K7PGcQVwrr9ZfcRD4Kx/?style=" + data.id, dataType: 'html', delay: 250 }) .done(function (html) { if ($('#citation_text').css('display') == 'none') { $('#citation_text').show() } $("#citation_text").html(html); }) .fail(function () { alert("Erro ao tentar obter esse estilo de citação"); }) }); }); // Garante que o valor do campo share_url é a URL corrente. $('#share_url').val(window.location.href); //moment.locale('en'); //$("#date").text(moment().format("L HH:mm:ss ZZ"));