Bilateral ureteric obstruction from pelvic endometriosis

Howard Woo, R. J. Millard, Gerard Wain
In: International Urogynecology Journal · 1994 · vol. 5(6) , pp. 363–365 · doi:10.1007/bf00418701 · W1979675952
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This case report describes a patient with bilateral ureteric obstruction from pelvic endometriosis presenting with acute hypertensive retinopathy and renal failure, who was treated surgically.

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This paper reports a clinical case of bilateral ureteric obstruction attributed to pelvic endometriosis, presenting with acute hypertensive retinopathy and renal failure. The authors describe surgical management with ureterolysis and omental wrapping, along with total hysterectomy and salpingo-oophorectomy, noting that nephrectomy was not done for the non-functioning kidney because the obstruction was relieved. A key caveat emphasized is the risk of recurrent symptomatic disease after conservative surgery for pelvic endometriosis, requiring long-term follow-up with attention to upper-tract monitoring by renal ultrasound. This paper is centrally about endometriosis — specifically, bilateral ureteric obstruction from pelvic endometriosis and its surgical management and follow-up implications.

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Abstract

Endometriosis is an uncommon cause of ureteric obstruction. When it occurs, unilateral involvement predominates. We report a case characterized by the unusual presentation of acute hypertensive retinopathy and renal failure. The patient was treated surgically by ureterolysis with omental wrapping, total hysterectomy and salpingo-oophorectomy. Nephrectomy was not performed on the non-functioning renal unit as the obstruction had been relieved. Patients who have previously been treated with conservative surgery for pelvic endometriosis are at risk of recurrent symptomatic disease, and require long-term follow-up with particular consideration being given to monitoring of the upper tracts by renal ultrasound. Similar content being viewed by others

References

Shook TE, Nyberg LM. Endometriosis of the urinary tract. Urology 1988;31:1–6. Patel A, Thorpe P, Ramsey JWA, Shepherd JH, Kirby RS, Hendry WF. Endometriosis of the ureter. Br J Urol 1992;69:495–498 Mourin-Jouret A, Squifflet JP, Cosyns JP, Pirson Y, Alexandrie GPJ. Bilateral ureteral endometriosis with end-stage renal failure. Urology 1987;30:302–306 Miller MAW, Morgan RJ. Bilateral ureteric obstruction due to endometriosis resulting in unilateral loss of renal function. Br J Urol 1990;65:421 Esen T, Akinci M, Ander H, Tunc M, Tellaloglu S, Narter I. Bilateral ureteric obstruction secondary to endometriosis. Br J Urol 1990;66:98–99 Lam AM, French M, Charnock FM. Bilateral ureteric obstruction due to recurrent endometriosis associated with hormone relacement therapy. Aust NZ J Obstet Gynecol 1992;32:83–84 Payne CK, Whitmore KE. Genitourinary endometriosis. AUA Update 1991;10:114–119 Moore JG, Hibbard LT, Growden WA, Schifrin BA. Urinary tract endometriosis: enigmas in diagnosis and management. Am J Obstet Gynecol 1979;134:162–172 Jepsen JM, Hansen KB. Danazol in the treatment of ureteral endometriosis. J Urol 1988;139:1045–1046 Heaps JM, Nieberg RK, Berek JS. Malignant neoplasms arising in endometriosis. Obstet Gynecol 1990;75:1023–1028 Tresidder GC, Blandy JP, Singh M. Omental sleeve to prevent retroperitoneal fibrosis under the ureter. Urol Int 1972;27:144–148 Author information Authors and Affiliations Rights and permissions About this article Cite this article Woo, H.H., Millard, R.J. & Wain, G.V. Bilateral ureteric obstruction from pelvic endometriosis. Int Urogynecol J 5, 363–365 (1994). https://doi.org/10.1007/BF00418701 Issue date: DOI: https://doi.org/10.1007/BF00418701

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