Hydronephrosis as a symptom of clinically silent ureteral endometriosis – case reports.

Abstract

Summary: Objective: We present two case reports of asymptomatic ureteral endometriosis leading to hydronephrosis. We demonstrate the significance of routine ultrasound scanning of the upper urinary tract in patients with diagnosed deep infiltrating endometriosis. Case reports: The first case report describes a symptomatic patient after a surgery for deep endometriosis. After the surgery she was completely without symptoms , but during regular check-ups progresive hydroneprohsis on the rigt side has developed and it did not respond to a conservative treatment. Surgery deliberation of ureter was indicated. The second case report describes a patient with already developed severe hydronephrosis on the left. The functional kidney examination proved a complete renal loss of the left kidney. Because of recurrent pyelonefritis in the afunction kidney nephrectomy was indicated. Conclusion: Ureteral endometriosis presents a rare, but insidious form of endometriosis, which is very often asymptomatic and late diagnosed. It can cause a complete silent loss of renal function. Routine ultrasound scanning examination of upper urinary tract in all patiens with diagnosed endometriosis could prevent this severe complication. 

Key words: Ureteral endometriosis – hydronephrosis – routine UZ scanning