Endometriosis of the Ureter (original) (raw)
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Ureteric Endometriosis: a 39 Years Old Lady Presented with Cyclical Lower Abdominal Pain
Journal of Dhaka Medical College, 2018
Endometriosis of Ureter is an uncommon presentation of a common diseases. It is divided into two groups: extrinsic & intrinsic. If the endometrial glands and stroma are present in the lamina propria or the tunica muscularis of ureter, the lesion is designated as intrinsic variety. When the endometrial glands and stroma are present in the adventitia and surrounding connective tissue and do not invade the tunica muscularis of ureter the lesion is classified as extrinsic variety.
Ureteral Endometriosis with Obstructive Uropathy
Internal Medicine, 2010
Endometriosis is a common disease, but ureteral involvement is rare. The symptoms and signs of ureteral endometriosis mimic those of ureteral malignancy. This case report describes a woman who presented with chronic back pain for 5 years. Imaging studies showed a right small contracted kidney with hydronephrosis and a bladder tumor. Endometriosis of the right lower ureter was ultimately diagnosed. The patient was healthy without recurrence during follow-up. It is difficult to differentiate between ureteral endometriosis and malignancy; in fact, renal loss may occur before diagnosis. Ureteral endometriosis should be considered for women with ureteral obstruction manifesting as chronic backache.
Radiographic Features of Intrinsic Ureteral Endometriosis: a case report
2005
Endometriosis is defined as the presence of endometrial tissue in an ectopic position. It occasionally involves the urinary tract. Ureteral endometriosis may be either intrinsic or extrinsic, where the intrinsic ureteral endometriosis refers to disease caused by the actual invasion of the ureteral wall by the endometriosis. This form has often been mistaken for a primary ureteral neoplasm, with consequent nephroureterectomy. We reported a case of ureteral endometriosis in a 47 year-old female patient suffered from unilateral hydronephrosis. Left antegrade pyelography revealed a tubular filling defect in the left distal ureter with left hydronephrosis, and computed tomography (CT) demonstrated a soft tissue in the left distal ureter. Under the impression of malignant urothelial tumor, segmental resection of distal ureter was performed. The pathologic findings revealed elements of endometrial glands and stroma in the ureteral lumen. Extragenital intraureteral endometriosis was diagnos...
PubMed, 2015
Recently, occurrence of urinary tract endometriosis (UTE) is more frequently diagnosed. According to literature, it refers to approximately 0.3 to even 12% of all women with endometriosis. The pathogenesis of UTE has not been clearly explained so far. The actually proposed hypotheses include embryonic, migration, transplantation, and iatrogenic theory. Most frequently UTE affects bladder, less often ureters and kidneys. One-third of patients remains asymptomatic or exhibits only minor manifestations. In symptomatic patients main complaints include dysuria, urinary urgency, and/or frequency, painful micturition, and burning sensation in the urethra and discomfort in the retropubic area. Treatment of UTE is challenging and can be pharmacological, surgical or can be a combination of both methods. In this paper we present a review of the literature concerning the UTE, its diagnosis and treatment.
Ureteral endometriosis – Our experience
Indian Journal of Obstetrics and Gynecology Research
Ureteral endometriosis is a rare disease affecting women of childbearing age, which presents with nonspecific symptoms and may lead to severe morbidity. The ureters can be involved either extrinsically and/or intrinsically by endometriosis. In this study we have retrospectively assessed the patients presenting to us with ureteral endometriosis. Between July 2009 and December 2019, (17) women of childbearing age presented to the urological services of the hospital with complaints of lower abdominal pain, dysmenorrhea, dysuria and a range of other symptoms. Pain in lower abdomen was the most common symptom and was cyclical in the majority of the patients. Only 2 patients had undergone surgery (diagnostic laparoscopy) previously for pain in abdomen and normal ultrasonography. Ureteric endometriosis is rare but a cause of severe morbidity in those that have deep infiltrating endometriosis. Can lead to ureteric obstruction and at times loss of function. An index of suspicion in women in ...
Urinary tract endometriosis: Review of 19 cases
Urology Annals, 2012
Endometriosis is characterized by the presence of endometrial tissue in the ectopic foci outside the uterus. Most commonly, it affects organs like ovaries, uterine ligaments, fallopian tubes, rectum and cervico-vaginal regions, but involvement of the urinary tract is rare (1-2%), [1] among which 84% involves the bladder. [2] We report our experience of 19 patients of urinary tract endometriosis. MATERIALS AND METHODS Patients with urinary tract endometriosis between Jan 2006 and May 2010 were retrospectively reviewed. From the records, age of patients, mode of presentation, location and size of lesion, history of prior surgery, reproductive wishes, how they were diagnosed, what radiological imaging they had undergone and what treatment they had received were analyzed. Patients underwent evaluation by urinalysis, including cytology, Aim: The aim of our study was to evaluate the treatment outcomes of medical and surgical management of urinary tract endometriosis. Materials and Methods: Urinary tract endometriosis patients enrolled between Jan 2006 and May 2010 were retrospectively reviewed. Preoperative datas (mode of presentation, diagnosis, imaging), intraoperative findings (location and size of lesion), postoperative histopathology and follow-up were recorded and results were analyzed and the success rate of different modalities of treatment was calculated. Results: In our study, of nineteen patients, nine had vesical involvement and ten had ureteric involvement. Among the vesical group, the success rate of transurethral resection followed by injection leuproide was 60% (3/5), while among the partial cystectomy group, the success rate was 100%. Among patients with ureteric involvement, success rate of distal ureterectomy and reimplantation was 100%, laparoscopic ureterolysis with Double J stenting followed by injection leuprolide was 75% while that of Gonadotropin-releasing hormone (GnRh) analogue alone was 67%. Conclusion: One should have a high index of suspicion with irritative voiding symptoms with or without hematuria, with negative urine culture, in all premenopausal women to diagnose urinary tract endometriosis. Partial cystectomy is a better alternative to transurethral resection followed by GnRh analogue in vesical endometriosis. Approach to the ureter must be individualised depending upon the severity of disease and dilatation of the upper tract to maximise the preservation of renal function.
Human Reproduction, 2015
In women with deeply infiltrating endometriosis (DIE) what is the prevalence of involvement of endometriotic tissue and fibrosis in ureteral endometriosis (UE), as assessed by histological staining? summary answer: In women with DIE, ureteral involvement is more often due to endometriotic tissue rather than fibrosis. what is known already: In the current literature, histological evaluation of ureteral endometriosis is mainly based on the degree of wall infiltration by endometriosis instead of the tissue composition. A few studies reported ill-defined and contradictory histological data on the tissue composition of UE. study design, size, duration: Retrospective observational study based on clinical records of women affected by DIE, laparoscopically treated for UE at a tertiary referral center, between January 2010 and March 2013. All cases of ureteral nodule excision or ureterectomy with histological examination of the specimens were included. Exclusion criteria were other identified causes of hydroureteronephrosis, medical therapy for a period of at least 3 months before surgery and previous surgery for DIE. participants/materials, setting, methods: A total of 77 patients were included in the study and among them seven (9%) presented with bilateral ureteral involvement, giving a total of 84 cases of UE available for analysis. All patients had stage IV endometriosis. According, respectively, to the presence of endometrial glands and/or stroma cells or of fibrotic tissue only, the endometriotic UE and fibrotic UE groups were compared with regard to hydroureteronephrosis at pre-operative urinary tract computerized tomography scan, type of surgical procedure performed to treat UE (nodule removal or ureterectomy), association with other locations of the disease and post-operative complications (ureteral fistula or stenosis). main results and the role of chance: For the 84 cases of UE, 65 (77%) and 19 (23%), respectively, showed endometriotic tissue and fibrotic tissue only. Presence of hydroureteronephrosis and endometriotic pattern of UE showed a significant association [endometriotic UE 44/65 (68%) versus fibrotic UE 8/19 (42%); P ¼ 0.04]. Fibrotic pattern of UE and presence of concomitant recto-vaginal endometriosis showed a significant association [endometriotic group: 29/65 (45%) versus fibrotic group 18/19 (95%); P , 0.001]. limitations, reasons for caution: The retrospective and monocentric (tertiary referral center) study design. wider implications of the findings: Besides the distinction between extrinsic and intrinsic UE based on the degree of wall infiltration by endometriosis, a new classification according to the histological pattern of UE could be useful for clinicians, both in the diagnostic and therapeutic fields. study funding/competing interest(s): None.
Ureteral endometriosis: A rare cause of silent obstructive uropathy
Marmara Medical Journal, 2016
Endometriosis is defined as the presence of active endometrial tissue outside the uterine cavity affecting 15% of women at reproductive age. Ureteral endometriosis (UE) is a rare type of endometrial involvement affecting 0.1%-1% of women with endometriosis. UE is quite uncommon and underdiagnosed because of the patients' nonspecific symptoms of endometriosis. However, it is important to diagnose and manage UE treatment since it can lead to renal failure due to silent obstruction of the ureter. This case report describes a woman who presented with cyclic pelvic pain and left flank pain. Imaging studies and laparoscopic findings revealed bilateral endometrioma and deep infiltrating endometriosis (DIE) findings resulting in extrinsic infiltration of the ureter and hydronephrosis.
URINARY TRACT ENDOMETRIOSIS: A CASE REPORT
Endometriosis affecting the urinary tract is rare and when involved it predominantly affects the bladder, followed by the ureter. The diagnosis of bladder endometriosis is difficult because of its varied clinical presentation. Here we report a case of bladder endometriosis, which was suspected pre-operatively and was confirmed after the histo pathological examination of the excised tissue.