Pelvic endometriosis and uretero-hydronephrosis: clinical, imagistic and surgical implications--case report.

C Ilea, I Lupaşcu, Ivona Lupaşcu, Demetra Socolov, A Cărăuleanu, Alexandru Cărăuleanu
Revista medico-chirurgicala a Societatii de Medici si Naturalisti din Iasi · 2015 · vol. 119(1) , pp. 170–4 · PMID:25970962 · W2434153622
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This case report details a patient with recurrent pelvic endometriosis causing uretero-hydronephrosis, necessitating surgical intervention including ureter reimplantation and anexectomy due to ureteral invasion.

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Abstract

UNLABELLED: Endometriosis represent the presence and proliferation of functional endometrial-like tissue outside the uterine cavity, and is a chronic, recurrent, debilitating desease, in which kidney implications are rare, but complex. OBJECTIVE: Evaluation of clinical, imagistic and surgical implications of uretero-hydronephrosis secondary to recurrent pelvic endometriosis. MATERIAL AND METHODS: 30 year old patient diagnosed with primary infertility and left ovarian endometriosis (treated with classically conservative surgical procedure), presented acute onset of obstructive urinary symptoms, requiring internal drainage of the upper urinary straight path (Cook probe) for uretero-hydronephrosis grade III. CT and MRI examination reveals the presence of a imprecise pelvic mass incorporating right distal ureter and uretero-bladder ostium. RESULTS: In this clinical and laboratory context, classic surgery is practicing with right anexectomy and direct right uretero-vesical reimplantation, also with psoas bladder-hitch. Histopathological examination confirmed the presence of recurrent ovarian endometriosis with right distal ureteral invasion. CONCLUSION: Recurent endometriosis, although considered a benign condition, often present invasive characters, determining considerable anatomical destructions and severe symptoms.

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Condition tags

endometriosisinfertility

MeSH descriptors

Endometriosis Hydronephrosis Hydronephrosis Ovarian Diseases Salpingectomy Ureter Urinary Bladder Adult Endometriosis Female Humans Hydronephrosis Hydronephrosis Ovarian Diseases Replantation Treatment Outcome Ureter Urinary Bladder Urologic Surgical Procedures Urologic Surgical Procedures

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