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Published on: October 12, 2017
A case of endometrioma causing ureteric obstruction
S Pati1, Bibek Mohan Rakshit, Amitava Mukhopadhyay
1Department of Obstetrics and Gynaecology, IPGME&R and SSKM Hospital, Kolkata 700020.
Journal of the Indian Medical Association
|September 16, 2010
Summary
A 32-year-old woman experienced lower abdominal pain and heavy irregular bleeding due to an ovarian endometrioma. Surgical resection resolved the endometrioma and associated hydronephrosis, with 2 months of danazol therapy prescribed.
Area of Science:
- Gynecology
- Reproductive Medicine
- Surgical Oncology
Background:
- Endometriomas, cysts arising from endometriosis on the ovary, can cause significant pelvic pain and menstrual irregularities.
- Infertility is a common complication associated with endometriosis, affecting a substantial number of women.
- Ovarian endometriomas can lead to secondary complications, including urinary tract obstruction, necessitating prompt diagnosis and management.
Observation:
- A 32-year-old woman presented with chronic lower abdominal pain and abnormal uterine bleeding, indicative of potential gynecological pathology.
- Diagnostic laparoscopy revealed a right ovarian endometrioma, and bimanual examination confirmed a palpable mass.
- Imaging studies, including ultrasound and intravenous pyelography, demonstrated right ureteral obstruction leading to hydroureter and hydronephrosis.
Findings:
- Surgical resection of the ovarian endometrioma was successfully performed.
- The patient's symptoms of pain and irregular bleeding were attributed to the endometrioma.
- Postoperative imaging confirmed resolution of the hydroureter and hydronephrosis following endometrioma removal.
Implications:
- This case highlights the importance of considering urinary tract involvement in patients with symptomatic ovarian endometriomas.
- Timely surgical intervention for ovarian endometriomas can prevent irreversible kidney damage caused by ureteral obstruction.
- Adjuvant medical therapy, such as danazol, may be considered postoperatively to manage residual endometriosis and reduce recurrence risk.
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