Endometriosis mimicking ureterolithiasis

Ureteric endometriosis: 3 case reports and a review of the literature

Endometriosis involving the ureter is a relatively rare phenomenon but at least 121 cases have been reported previously. The 3 cases presented in this report emphasize some important facets of this condition: the lack of symptoms leading to late diagnosis, the presence of severe renal damage with very localized pelvic disease, how an incomplete initial operation may lead to further major difficulties, and the failure of medical therapy to halt its progress. The potentially lethal nature of ureteric endometriosis is stressed, and the different treatment modalities for patients of different ages and parity discussed. Surgical management, either conservative or radical, is suggested as the modality of choice, and where conservative operation is undertaken very careful continuing observation of renal function is a necessity.

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.

Laparoscopy as a diagnostic aid in women with localized ureteral obstruction due to endometriosis

Endometriosis is a common disease which can produce localized ureteral obstruction. Many women will have significant disease without any clinical signs or symptoms until they present with distal ureteral obstruction. In the reported literature, the diagnosis of ureteral involvement by endometriosis usually has been made at surgery. It is therefore suggested that women with distal ureteral obstruction not attributable to calculous disease undergo laparoscopy in an attempt to rule out endometriosis as the cause of ureteral obstruction.

Urinary tract endometriosis: enigmas in diagnosis and management

The diagnosis and management of endometriosis presents several enigmas. This review, of eight patients with endometriosis involving the urinary tract, from three large clinical services in the City of Los Angeles, highlights some very difficult problems. Not only diagnostic errors but also inappropriate conservatism and inadequate surveillance have led to compromised function, resection, and/or destruction of the kidneys, ureters, or bladder. The series indicates those findings which are likely to result in urinary tract destruction and points out those clinical situations in which delays or conservative management must be undertaken only with pressing indications and then only with continued and careful surveillance.