Urinary diversion in a case of bilateral ureteral endometriosis

Abstract

Endometriosis of the urinary tract is uncommon. We report a case of bilateral ureteral endometriosis. A 46-years-old woman was presented with facial edema. The level of blood urea nitrogen and creatinine were 52 and 4.83 mg/dl respectively at the first examination. Retrograde urography demonstrated bilateral hydronephrosis with distal ureteral obstruction and MRI (magnetic resonance imaging) showed left ovarian cyst. CA125 level was 93 U/ml. We diagnosed the case as ureteral endometriosis by exploratory laparotomy. After 16 month of gonadotropin-releasing hormone analogue therapy and ureteral dilation with catheter, she underwent end-to-side uretero-ureterostomy with ureteral reimplantation (psoas hitch). Bilateral hydronephrosis and renal function were improved after the operation. The case was suspected of extrinsic type ureteral endometriosis.