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Ureteral endometriosis is asymptomatic in as many as 50% of patients. Because of nonspecific symptoms and nonspecific imaging findings, incorrect diagnosis of ureteral endometriosis can lead to obstructive uropathy and renal damage. A 32 year P2L2 woman with history of left flank pain. Despite several evaluations by physicians, including gynaecologists, the cause of her symptoms was not diagnosed. Left ureteral endometriosis was suspected (Fig. 1). Laparoscopic distal ureterectomy with neocystostomy (Figs. 2, 3, 4) and double-J ureteral stent insertion were performed and the same removed after 3 months. Surgery is necessary in patients with ureteral endometriosis who have persistent symptoms and/or hydroureteronephrosis or impaired renal function. The main goals of surgery are preservation of renal function, relief of obstruction, and prevention of recurrence. Meenakshi Sundaram, MBBS, MD, DNB, is a Consultant Gynecological Endoscopic and Robotic Surgeon at Apollo Women’s Hospital, Chennai; Rachita Munjal, MBBS, MS, FRM is a Fellow in Reproductive Medicine and Surgery at Apollo Hospital, Chennai and in Department of Obstetrics and Gynaecology at Apollo Hospital, Chennai; Juhul Patel, MBBS, DGO, DMLS is a Senior Resident in Department of Obstetrics and Gynaecology at Apollo Hospital, Chennai.

Deep Infiltrating Ureteral Endometriosis with Hydroureteronephrosis: A Case Report