Acute Renal Failure due to Obstructive Uropathy Secondary to Ureteral Endometriosis.

Jeong In Choi,Sa Jin Kim,Hae Nam Lee,Jee Geun Yoo,Min Jeong Kim

doi:10.1155/2015/761348

Jeong In Choi, Sa Jin Kim + Show 3 more

Open Access

https://doi.org/10.1155/2015/761348

Copy DOI

Abstract

Ureteral involvement by endometriosis is a rare and often silent disease but capable of producing significant morbidity and leading to hydronephrosis and to renal failure. Surgery is the treatment of choice to remove endometriotic lesions and relieve ureteral obstruction if the kidney is still functional or a nephrectomy is performed if there is a complete loss of renal function. We report a case of acute renal failure induced ureteral endometriosis managed with laparoscopic unilateral nephrectomy and endometrioma cystectomy. Differential diagnosis is important to confirm diagnosis for patients with ureteral obstruction presenting nonspecific symptoms.

Highlights

Endometriosis occurs at a high incidence of 15% among reproductive women [1], but it rarely develops into decreased renal function by ureteral endometriosis [2, 3]
Ureteral endometriosis accounts for only a minority of cases (0.1– 0.4%) [4], but the incidence is increased to 10–14% in women with rectovaginal endometriotic nodules of more than 3 cm in size [5, 6]
We report a case of acute renal failure with hydronephrosis due to obstructive uropathy secondary to ureteral endometriosis, managed with laparoscopic unilateral nephrectomy, endometrioma cystectomy, adhesiolysis, and Double J catheter insertion into the right ureter

Summary

Introduction

Endometriosis occurs at a high incidence of 15% among reproductive women [1], but it rarely develops into decreased renal function by ureteral endometriosis [2, 3]. Ureteral endometriosis accounts for only a minority of cases (0.1– 0.4%) [4], but the incidence is increased to 10–14% in women with rectovaginal endometriotic nodules of more than 3 cm in size [5, 6]. It is usually diagnosed in reproductive women of 30–35 years of age, but it is rare in postmenopausal women [3]. Due to the rare incidence and nonspecific symptoms, ureteral endometriosis should be carefully diagnosed with excluding differential diagnosis and adequately performed prompt treatment

Case Presentation

Discussion

Findings

Method