Management of ureteral endometriosis and review of the literature

Özet

Endometriosis can affect 10-15% of the women in their reproductive age and it is characterized with thepresence of the functional endometrium tissue outside the uterine cavity. Up to 10% of the cases with urinary system endometriosis may involve the ureter. Left distal ureter is the most common site of involvement.The differentiation between intrinsic and extrinsic endometriosis is very substantial for the selection andapplication of definitive treatment. Medical and surgical treatment alternatives are available for endometriosis management and histopathologic examination is required for definitive diagnosis. In this case report, a33-year-old patient underwent segmental ureter excision and ureteroureteral anastomosis due to endometriosis causing obstruction in the left distal ureter. The operation was performed through a left Gibson incisionand a 6 Fr double J stent was implanted in the ureter. The stent was removed after 4 weeks and the controlmagnetic resonance imaging-urography was performed at 3 months postoperatively. Obstruction and hydroureteronephrosis were observed to be completely regressed in control. If there is no other obvious etiologyfor the presence of unilateral hydroureteronephrosis in women in their reproductive age, the diagnosis ofendometriosis should be considered.