Dysmenorrhea in Renal Obstruction (Intrinsic Ureteral Endometriosis)

Extrauterine endometriosis occurs in less than 1% of cases and rarely involves the urinary system. Ureteral endometriosis is a rare disorder that can eventually lead to renal dysfunction/failure with an incidence of <1%. Ureteral obstruction resulting in hydronephrosis is a rare manifestation of ureteric endometriosis. It occurs as a consequence of intrinsic involvement of the ureter or from extrinsic compression by a pelvic endometriosis. Presented is a 42-year-old adult female with left sided intrinsic ureteral endometriosis presenting with left cyclical flank pain masked by dysmenorrhea.