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Hydronephrosis due to ureteral endometriosis treated by transperitoneal laparoscopic ureterolysis
Author(s) -
WATANABE YUICHI,
OZAWA HIDEO,
UEMATSU KATSUTOSHI,
KAWASAKI KENSUKE,
NISHI HIDEYUKI,
KOBASHI YUJI
Publication year - 2004
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.2004.00828.x
Subject(s) - ureterolysis , medicine , ureter , endometriosis , hydronephrosis , hydroureter , surgery , ectopic ureter , urology , radiology , urinary system , anatomy
Ureteral obstruction secondary to endometriosis is relatively uncommon. We present a 43‐year‐old multiparous woman who suffered from periodic left loin pain in the terminal period of her menstruation. Excretory urogram demonstrated left hydronephrosis and hydroureter and obstruction of the lower left ureter just inferior to the left sacroiliac joint without urolithiasis. An enhanced computed tomography scan showed soft tissue density mass around the left ureter at the level of the stenosis. She underwent transperitoneal laparoscopic ureterolysis and adhesiotomy of the left ureter under the diagnosis of ureteral endometriosis. Because blueberry spots were clearly observed on the pelvic brim, the fibrous tissue surrounded the ureter was removed with peritoneal bleeding spots. Histological examination of the surrounding tissue confirmed the ectopic endometriosis. Even though retroperitoneoscopy is frequently used for ureteral lesion, transperitoneal laparoscopy has an advantage for resection of ectopic endometriosis surrounding the ureter.