Ureteral endometriosis in postmenopausal woman

A Rare Case Report about an Extrinsic Ureteral Endometriosis

Endometriosis represents extrauterine nonneoplastic endometrial tissue. Involvement of the genitourinary tract has been reported at an incidence of about 1.2% and ureteral endometriosis is a rare entity. There are two major pathological types of ureteral endometriosis extrinsic and intrinsic. Here, we describe a case report about an ureteral endometriosis extrinsic with double collecting system and complete ureteral duplication.

Ureteral endometriosis

PURPOSE

This review discusses the pathophysiology, presentation, and different minimally invasive medical and surgical treatment options for ureteral endometriosis.

MATERIALS AND METHODS

A comprehensive literature review of reports on the diagnosis and management of ureteral endometriosis was performed using MEDLINE.

RESULTS

Ureteral endometriosis is a rare disease. Most cases present with silent obstruction, as opposed to cyclical hematuria. The diagnosis of ureteral endometriosis requires a high index of suspicion. A variety of diagnostic tests can help identify the extent of disease and the degree of renal function on the side of ureteral involvement.

CONCLUSIONS

Ureteral endometriosis can be treated with hormones or surgical intervention. While surgery is reserved for hormone refractory cases and obstruction associated with extensive scarring, the majority of cases can be managed with hormones only. A combination of hormones and surgery is also effective. Surveillance for obstructive uropathy with periodic noninvasive monitoring of kidney function is currently recommended for all patients with endometriosis.

Endometriosis of the urinary tract

Genitourinary endometriosis is a rare manifestation of a common disease. Ectopic endometrial tissue may extrinsically involve or intrinsically invade the bladder or ureter, and, less commonly, the urethra or kidney. Bladder involvement usually presents with irritative symptoms, whereas ureteral disease may present with asymptomatic renal failure. Therefore, a high index of suspicion is necessary, and genitourinary endometriosis should be considered in all symptomatic women with a history of cesarean delivery of other gynecologic surgery. In women beyond reproductive age, definitive surgical treatment is preferred, with removal of the ectopic tissue, relief of obstruction, and castration with or without hysterectomy. In those who desire future fertility, conservative surgery and/or hormonal therapy is often recommended.

A case of cutaneous endometriosis developed in postmenopausal woman receiving hormonal replacement

Cutaneous endometriosis is characterized by the presence of extrauterine endometrial tissue in or under the skin. We report a case of cutaneous endometriosis in postmenopausal woman who was receiving hormonal replacement.

Extrapelvic endometriosis

This article reviews extrapelvic endometriosis, emphasizing classic papers as well as recent research. Because of the nature of the existing literature, specifically case reports and retrospective analyses, this article is primarily descriptive in nature. Extrapelvic endometriosis is discussed based on some main areas of occurrence, including gastrointestinal, urinary, and thoracic; other areas are also reviewed. What is known about the epidemiology, pathogenesis, diagnosis, and treatment of extrapelvic endometriosis is highlighted. Areas for future direction of research in the field are also identified.

Vesical endometriosis: report of two cases and review of the literature

Endometriosis is a common gynecologic disease in which endometrial tissue is deposited outside the normal confines of the uterine cavity. In rare instances, endometriosis involves the urinary tract, with the bladder the most frequent organ affected. Classic presenting symptoms include cyclic irritative voiding symptoms and suprapubic discomfort with or without hematuria. Both medical and surgical management have been advocated, but surgical extirpation is probably more efficacious. Two cases of endometriosis involving the the bladder are presented and contrasted in terms of pathophysiology. Contemporary management of this condition is reviewed, and guidelines for diagnosis and treatment are proposed.

Endometriosis of bladder after menopause

We report a rare case of endometriosis of the bladder in a 68-year-old postmenopausal woman. The patient had not received any exogenous estrogen therapy and the hormone levels were normal for a castrated female subject. Endometriosis of the bladder should be considered as a cause of an abnormal mass of the bladder even after menopause. This case documents that urinary involvement by endometriosis may persist even after years of a hormonally castrated state.

Case report and review of the literature: ureteral endometriosis

Endometriosis is a common disorder affecting women of all ages. Although urinary tract involvement is not uncommon, ureteral obstruction is an infrequent complication of endometriosis. A case is reported of acute renal failure caused by bilateral ureteral obstruction resulting from extensive pelvic endometriosis. All reported cases of ureteral endometriosis are reviewed with special emphasis on bilateral ureteral involvement. Physicians need to be aware of this reversible complication of endometriosis.

Ureteral endometriosis: an endoscopic diagnosis

A case of ureteral endometriosis is reported. This is the first case diagnosed during a ureteropyeloscopic examination.

Ureteral endometriosis in post-menopausal women

Ureteral obstruction secondary to endometriosis is an infrequently observed phenomenon, particularly in post-menopausal women. Two patients with obstructive uropathy, aged fifty-five and seventy-four, underwent ureteroplasty procedures with pathologic documentation of endometriosis. The possible pathogenetic mechanisms of ureteral endometriosis and previously reported cases are cited.