An unusual case of bilateral hydroureter: solved by a gynaecologist
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20180937Keywords:
Bilateral hydroureter, Dysmenorrhoea and hesitancy, Hydronephrosis, IVP, MRIAbstract
A 26-year unmarried girl presented with severe dysmenorrhoea and hesitancy of micturition during menses since, 2 years. She had history of regular menstruation. On IVP and ultrasound there was presence bilateral hydroureter and hydronephrosis. She had previous history of cystoscopy with bilateral ureteroscopy done for the same. Bilateral ureteric stenting for a period of 3 months was done 1 year earlier, however it failed to resolve the hydroureter. A MRI was done, which showed hydroureter with surrounding endometriotic nodule. Laparoscopy was done, and ureteral shaving was performed. Postoperative IVP showed normal ureteral and renal pelvic anatomy. Patient is presently on Dienogest and is asymptomatic.
References
Bulletti C, Coccia M, Battistoni S, Borini A. Endometriosis and infertility. J Assisted Reproduct Genetic. 2010;27(8):441-7.
Rousselot F, Liard-Meillon ME. Renal endometriosis. Report of one case. Prog Urol 1996;6:936-9.
Stillwell T, Kramer S, Lee R. Endometriosis of ureter. Urol. 1986;28(2):81-5.
Yohannes P. Ureteral endometriosis. J Urol. 2003;170:20-5.
Pérez M, Aguilera Bazán A, Alonso Dorrego JM, Hernández A, de Francisco MG, Martín Hernández M, et al. Urinary tract endometriosis: clinical, diagnostic, and therapeutic aspects. Urol. 2009;73:47-51.
Abrão MS, Podgaec S, Dias JA, Averbach M, Silva LF, Marino de Carvalho F. Endometriosis lesions that compromise the rectum deeper than the inner muscularis layer have more than 40% of the circumference of the rectum affected by the disease. J Minim Invasive Gynecol. 2008;15:280-5.
Seracchioli R, Mabrouk M, Manuzzi L, Guerrini M, Villa G, Montanari G, et al. Importance of retroperitoneal ureteric evaluation in cases of deep infiltrating endometriosis. J Minim Invasive Gynecol. 2008;15:435-9.
Vercellini P, Somigliana E, Viganò P, Abbiati A, Barbara G, Fedele L. Chronic pelvic pain in women: etiology, pathogenesis and diagnostic approach. Gynecol Endocrinol 2009;25:149-58.
Giri SK, Long RM, Barry D, Flood HD, Moran KT. Ureteral endometriosis and ovarian mucinous cystadenoma presenting with acute pyonephrosis. Ir J Med Sci. 2005;174:67-70.
Ghezzi F, Cromi A, Bergamini V, Bolis P. Management of ureteral endometriosis: areas of controversy. Curr Opin Obstet Gynecol. 2007;19:319-24.
Generao SE, Keene KD, Das S. Endoscopic diagnosis and management of ureteral endometriosis. J Endourol. 2005;19:1177-9.
Horn LC, Do Minh M, Stilzenburg JU. Intrinsic form of ureteral endometeriosis causing ureteral obstruction and partial loss of kidney function. Urol Int. 2004;73:181-4.
Marcelli F, Collinet P, Vinatier D, Robert Y, Triboulet JP, Biserte J, et al. Ureteric and bladder involvement of deep pelvic endometriosis. Value of multidisciplinary surgical management. Prog Urol. 2006;16:588-93.