Ureteral endometriosis: an uncommon cause of ureteral stricture

Apostolos Vrettos, Maria Prasinou, Prasinou M, Frymann R, R. Frymann, Rob Frymann
Quantitative Imaging in Medicine and Surgery · 2016 · vol. 6(2) , pp. 231–232 · doi:10.21037/qims.2016.01.02 · PMID:27190779 · PMC4858465 · W2274526034
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This paper discusses ureteral endometriosis, an uncommon cause of ureteral stricture that can lead to silent obstruction, hydronephrosis, and potentially renal failure in women of reproductive age.

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

This paper reports a single 43-year-old woman with recurrent right-sided colicky pain and hydronephrosis, in whom imaging (CT KUB, IVU, and MRI) suggested right distal ureteral narrowing without a clear cause. Laparoscopy with histologic assessment identified endometrial tissue encasing the distal ureter, and because the stenosis was near the ureterovesical junction she underwent open ureterocystoneostomy, after which her pain resolved and renal function remained stable on outpatient follow-up. A key limitation is that the evidence is based on one case, so broader diagnostic performance or treatment comparisons are not established. This paper is centrally about endometriosis — it describes ureteral endometriosis as an uncommon cause of ureteral stricture and hydronephrosis.

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Abstract

Endometriosis is a common disorder which affects 5–10% of women of reproductive age, for which the gold standard investigation for the diagnosis is laparoscopy and biopsy with histological confirmation (1,2). Urinary tract endometriosis occurs in ~1% of women with pelvic endometriosis (3). If it involves the ureters, it can present with renal colic and can cause hydronephrosis and renal complications due to obstruction, mainly in women of child-bearing age. The symptoms can be non-specific. Delayed diagnosis can lead to renal failure due to silent obstruction of the ureter (4).
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Acknowledgements

None. Footnote Conflicts of Interest: The authors have no conflicts of interest to declare.

References

- Olive DL, Schwartz LB. Endometriosis. N Engl J Med 1993;328:1759-69. [Crossref] [PubMed] - Coleman L, Overton C. GPs have key role in early diagnosis of endometriosis. Practitioner 2015;259:13-7, 2. - McGuire EJ, Gudziak M, O'Connell H, Ali V. Gynecological aspects of urology. In: Gillenwater JY, Grayhack JT, Howard SS, Duckett JW, editors. Adult and Pediatric Urology. Mosby, St Louis 1996:1853-78. - Al-Khawaja M, Tan PH, MacLennan GT, Lopez-Beltran A, Montironi R, Cheng L. Ureteral endometriosis: clinicopathological and immunohistochemical study of 7 cases. Hum Pathol 2008;39:954-9. [Crossref] [PubMed] - Umar SA, MacLennan GT, Cheng L. Endometriosis of the ureter. J Urol 2008;179:2412. [Crossref] [PubMed] - Balleyguier C, Roupret M, Nguyen T, Kinkel K, Helenon O, Chapron C. Ureteral endometriosis: the role of magnetic resonance imaging. J Am Assoc Gynecol Laparosc 2004;11:530-6. [Crossref] [PubMed] - Kerr WS Jr. Endometriosis involving the urinary tract. Clin Obstet Gynecol 1966;9:331-57. [Crossref] [PubMed] - Mereu L, Ruffo G, Landi S, Barbieri F, Zaccoletti R, Fiaccavento A, Stepniewska A, Pontrelli G, Minelli L. Laparoscopic treatment of deep endometriosis with segmental colorectal resection: short-term morbidity. J Minim Invasive Gynecol 2007;14:463-9. [Crossref] [PubMed] - Stepniewska A, Grosso G, Molon A, Caleffi G, Perin E, Scioscia M, Mainardi P, Minelli L. Ureteral endometriosis: clinical and radiological follow-up after laparoscopic ureterocystoneostomy. Hum Reprod 2011;26:112-6. [Crossref] [PubMed]

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