Endometriosis of the ureteral stump: an entity with severe manifestations

Paolo Viganò, Jessica Ottolina, Renzo Colombo, Gianluca Taccagni, Stefano Ferrari, Massimo Candiani
In: Clinical and Experimental Obstetrics & Gynecology · 2017 · vol. 44(4) , pp. 634–636 · doi:10.12891/ceog3700.2017 · W2807354976
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-07 ⓘ

Endometriosis of a residual ureteral stump caused severe symptoms 15 years after nephrectomy, indicating proximal ureterectomy is recommended to prevent long-term complications.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This case report describes a 50-year-old woman with a long history of endometriosis who, despite continuous oral estroprogestin therapy and being asymptomatic for 15 years after total nephrectomy, developed gross hematuria and right reno-ureteral colic due to endometriosis in a residual ureteral stump. Imaging suggested ureteral stump endometriosis, but urothelial cancer or carcinoma arising in an endometriotic nodule could not be excluded preoperatively. Laparoscopic hysterosalpingo-oophorectomy with removal of the residual ureteral stump found histologically confirmed endometriotic implants on the ureteral stump wall; the paper’s key limitation is that it is a single-patient report. Relevance to endometriosis: the paper is centrally about endometriosis involving the ureteral stump, describing severe late complications despite prior treatment and a non-functioning kidney.

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Abstract

A 50-year-old woman on continuous oral estroprogestin therapy and with a history of endometriosis presented with gross hematuria and right reno-ureteral colic pain. Fifteen years before she had undergone total nephrectomy for loss of function of her right kidney due to an ureteral endometriotic nodule resulting in ureteral obstruction. The ureter had not been removed. For the following 15 years-period she had not manifested symptoms or signs of endometriosis. Although imaging investigations allowed to suspect endometriosis of the ureteral stump, urothelial cancer or carcinoma arising in endometriosis nodule could not be excluded. A laparoscopic hysterosalpingo-oophorectomy with the residual ureteral stump removal was performed. Some endometriotic implants on the ureteral stump wall were histologically detected. Proximal ureterectomy should be recommended in patients affected by ureteral endometriosis with a non-functioning kidney since long-term severe complications could derive from the residual stump. A continuous estroprogestin therapy does not totally prevent these complications.
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Abstract

A 50-year-old woman on continuous oral estroprogestin therapy and with a history of endometriosis presented with gross hematuria and right reno-ureteral colic pain. Fifteen years before she had undergone total nephrectomy for loss of function of her right kidney due to an ureteral endometriotic nodule resulting in ureteral obstruction. The ureter had not been removed. For the following 15 years-period she had not manifested symptoms or signs of endometriosis. Although imaging investigations allowed to suspect endometriosis of the ureteral stump, urothelial cancer or carcinoma arising in endometriosis nodule could not be excluded. A laparoscopic hysterosalpingo-oophorectomy with the residual ureteral stump removal was performed. Some endometriotic implants on the ureteral stump wall were histologically detected. Proximal ureterectomy should be recommended in patients affected by ureteral endometriosis with a non-functioning kidney since long-term severe complications could derive from the residual stump. A continuous estroprogestin therapy does not totally prevent these complications.

Keywords

- Endometriosis - Estroprogestins - Nephrectomy - Ureteral stump - Ureterectomy

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endometriosis

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