Endometriosis presenting with right side hydroureteronephrosis only: a case report

Area of Science:

• Gynecology
• Urology
• Pathology

Background:

• Endometriosis is characterized by endometrial tissue outside the uterus.
• Urinary tract involvement, though uncommon, can occur.
• This case focuses on a rare presentation of endometriosis within the ureter.

Observation:

• A 30-year-old woman presented with flank pain, dysuria, and suprapubic pain.
• Initial investigations revealed right hydroureteronephrosis without signs of kidney stones.
• Ureteroscopy identified a distal ureteral stricture, leading to surgical intervention.

Findings:

• Pathologic examination of the resected ureter confirmed intrinsic endometriosis.
• Endometrial glandular cells and stromal tissue were identified within the ureteral wall.
• This confirmed the cause of the ureteral obstruction and hydroureteronephrosis.

Implications:

• Premenopausal women with unexplained distal ureteral obstruction should be evaluated for endometriosis.
• Treatment aims to preserve renal function, relieve obstruction, and prevent recurrence.
• This case underscores the importance of considering endometriosis in atypical urologic presentations.