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Endometriosis presenting as hydronephrosis
Ahmed Bakheet Zaharani1, G V Soundra Pandyan
1Department of Urology, Assir Central Hospital, King Khalid College of Medical Sciences, Abha, Saudi Arabia.
Thescientificworldjournal
|October 18, 2005
Summary
Endometriosis can cause serious kidney damage (hydronephrosis) due to ureteric obstruction. Early diagnosis and treatment are crucial, as demonstrated by a case requiring surgical intervention for ureteric stricture.
Area of Science:
- Urology
- Gynecology
- Pathology
Background:
- Endometriosis is a condition where uterine tissue grows outside the uterus.
- Ureteric involvement in endometriosis can lead to hydronephrotic renal atrophy, a severe urological complication.
- Diagnosis is often delayed due to non-specific symptoms and reliance on clinical suspicion.
Observation:
- A young, unmarried female presented with a 2-year history of left loin pain.
- Imaging revealed a lower ureteric stricture causing hydronephrosis secondary to pelvic endometriosis.
- The patient had a family history of endometriosis but no menstrual irregularities.
Findings:
- Initial treatment with diagnostic laparoscopy, ureteric stenting, and hormonal therapy failed to resolve the ureteric obstruction.
- Surgical management, including endometrioma excision, left oophorectomy, and ureteric reconstruction (uretero-ureterostomy), was ultimately required.
- Histopathological confirmation of endometriosis was obtained from the resected lesion.
Implications:
- This case highlights the importance of considering endometriosis in young women with unexplained loin pain and obstructive uropathy.
- Aggressive management, including surgical intervention, may be necessary when conservative treatments are ineffective for ureteric endometriosis.
- Awareness of this urological complication is vital for timely diagnosis and prevention of irreversible renal damage.