Bilateral Ureteric Obstruction Due to Recurrent Endometriosis Associated with Hormone Replacement Therapy

A M Lam, M French, F M Charnock
The Australian & New Zealand journal of obstetrics & gynaecology · 1992 · vol. 32(1) , pp. 83–84 · doi:10.1111/j.1479-828x.1992.tb01910.x · PMID:1586345 · W2074409174
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This case report discusses a patient experiencing bilateral ureteric obstruction from recurrent endometriosis after hormone replacement therapy, highlighting the debate around its use post-oophorectomy in women with a history of endometriosis.

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Abstract

EDITORIAL COMMENT : We accepted this case report for publication since it addresses the important problem of whether hormone replacement therapy should be withheld after bilateral oophorectomy (usually associated with hysterectomy) in the premenopausal woman who had extensive endometriosis. Our endocrinologist reviewer withholds oestrogen for 6 months in such women and prescribes medroxyprogesterone acetate 10 mg BD continuously if they have flushes or associated symptoms; he is especially unwilling to prescribe oestrogen if removal of endometriotic deposits is deemed by the surgeon to be incomplete. Our editorial panel consensus is that it is cruel to withhold oral hormone replacement therapy from these women but that the regimen should include a progestogen as well as oestrogen as in women who still have a uterus. We agree with the authors that we need data telling us how often hormone replacement therapy is associated with return of symptoms due to endometriotic deposits ‐ in the editor's experience the problem is uncommon. Our Senior Gynaecologist Chairman states that in the few patients he has managed in whom endometriosis has been reactivated by hormone replacement therapy after pelvic clearance, the problem has been controlled by low‐dose X‐ray therapy ‐ in his experience this has not resulted in ureteric obstruction although he has seen 2 women present with unilateral ureteric obstruction from previously untreated endometriosis involving the lateral pelvic wall.

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Condition tags

mesh:D004715endometriosis

MeSH descriptors

Endometriosis Neoplasm Recurrence, Local Pelvic Neoplasms Ureteral Obstruction Adult Endometriosis Endometriosis Endometriosis Estradiol Estradiol Estradiol Estrogen Replacement Therapy Estrogen Replacement Therapy Female Humans Neoplasm Recurrence, Local Pelvic Neoplasms Pelvic Neoplasms Pelvic Neoplasms Ureter

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (9)

Cited by (20)

Source provenance

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