Ureteral stenosis due to DIE (deep infiltrating endometriosis) with difficulty in treatment

Case report and brief literature review

Kuniaki Ota, Kenji Sato, Mamoru Tanaka

Research output: Contribution to journalArticle

Abstract

Ureteral involvement is rare, with an estimated frequency of 10-14% in cases of deep infiltrating endometriosis. An important complication of ureteral involvement is asymptomatic loss of renal function. We reported that a 49-year-old woman presented with chronic pelvic pain due to severe dysmenorrhea and without any urological symptoms. Magnetic resonance imaging (MRI) identified a 7 cm endometrioma compressing and infiltrating the rectal wall, and chronic left hydronephrosis. Isotope renogram decreased 14% function in the left kidney. We performed adhesiolysis, freeing of the uterus and appendages, hysterectomy, bilateral oophorectomy. However, we performed only to resect a part of left deep infiltrating endometriosis with ureteral involvement to avoid ureteral injury. After surgery, hydronephrosis was improved and those endometriosis left was not enlarged after 1 years of follow-up. We have to consider bilateral oophorectomy since endometriosis develops by the estrogen-dependent and it may decrease reproductive hormone derived from ovary.

Original languageEnglish
JournalGynecology and Minimally Invasive Therapy
DOIs
Publication statusAccepted/In press - 2017

Fingerprint

Endometriosis
Pathologic Constriction
Hydronephrosis
Ovariectomy
Kidney
Therapeutics
Dysmenorrhea
Pelvic Pain
Hysterectomy
Isotopes
Chronic Pain
Uterus
Ovary
Estrogens
Magnetic Resonance Imaging
Hormones
Wounds and Injuries

Keywords

  • Deep infiltrating endometriosis
  • Hydronephrosis
  • Laparoscopy
  • Peri-menopausal women

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

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title = "Ureteral stenosis due to DIE (deep infiltrating endometriosis) with difficulty in treatment: Case report and brief literature review",
abstract = "Ureteral involvement is rare, with an estimated frequency of 10-14{\%} in cases of deep infiltrating endometriosis. An important complication of ureteral involvement is asymptomatic loss of renal function. We reported that a 49-year-old woman presented with chronic pelvic pain due to severe dysmenorrhea and without any urological symptoms. Magnetic resonance imaging (MRI) identified a 7 cm endometrioma compressing and infiltrating the rectal wall, and chronic left hydronephrosis. Isotope renogram decreased 14{\%} function in the left kidney. We performed adhesiolysis, freeing of the uterus and appendages, hysterectomy, bilateral oophorectomy. However, we performed only to resect a part of left deep infiltrating endometriosis with ureteral involvement to avoid ureteral injury. After surgery, hydronephrosis was improved and those endometriosis left was not enlarged after 1 years of follow-up. We have to consider bilateral oophorectomy since endometriosis develops by the estrogen-dependent and it may decrease reproductive hormone derived from ovary.",
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AU - Sato, Kenji

AU - Tanaka, Mamoru

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N2 - Ureteral involvement is rare, with an estimated frequency of 10-14% in cases of deep infiltrating endometriosis. An important complication of ureteral involvement is asymptomatic loss of renal function. We reported that a 49-year-old woman presented with chronic pelvic pain due to severe dysmenorrhea and without any urological symptoms. Magnetic resonance imaging (MRI) identified a 7 cm endometrioma compressing and infiltrating the rectal wall, and chronic left hydronephrosis. Isotope renogram decreased 14% function in the left kidney. We performed adhesiolysis, freeing of the uterus and appendages, hysterectomy, bilateral oophorectomy. However, we performed only to resect a part of left deep infiltrating endometriosis with ureteral involvement to avoid ureteral injury. After surgery, hydronephrosis was improved and those endometriosis left was not enlarged after 1 years of follow-up. We have to consider bilateral oophorectomy since endometriosis develops by the estrogen-dependent and it may decrease reproductive hormone derived from ovary.

AB - Ureteral involvement is rare, with an estimated frequency of 10-14% in cases of deep infiltrating endometriosis. An important complication of ureteral involvement is asymptomatic loss of renal function. We reported that a 49-year-old woman presented with chronic pelvic pain due to severe dysmenorrhea and without any urological symptoms. Magnetic resonance imaging (MRI) identified a 7 cm endometrioma compressing and infiltrating the rectal wall, and chronic left hydronephrosis. Isotope renogram decreased 14% function in the left kidney. We performed adhesiolysis, freeing of the uterus and appendages, hysterectomy, bilateral oophorectomy. However, we performed only to resect a part of left deep infiltrating endometriosis with ureteral involvement to avoid ureteral injury. After surgery, hydronephrosis was improved and those endometriosis left was not enlarged after 1 years of follow-up. We have to consider bilateral oophorectomy since endometriosis develops by the estrogen-dependent and it may decrease reproductive hormone derived from ovary.

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