尿管子宮内膜症による水腎症8例の検討

Abstract

尿管子宮内膜症8例について, 臨床像と治療法を検討した.主訴は疼痛6例, 肉眼的血尿1例, 無症状の水腎症1例であった.症状が月経周期によって変化を示したのが1例のみであった.水腎症の治療は尿管カテーテル留置を3例, ホルモン療法を4例に施行した.手術治療は全例に施し, 膀胱尿管新吻合術4例, 腎尿管全摘出2例, 尿管端々吻合術1例および術式不明1例であった.尿管の子宮内膜症の治療は, ホルモン療法を試み, 改善のみられないものや再発するものに対しては, 早急に手術療法で対処すべきである

We report 8 cases of ureteral endometriosis. The mean age of the 8 patients was 42 years (range 29 to 60). In all patients, endometrial lesions were located in the lower third of the ureter and were unilateral. Six patients presented with flank pain and in one of the 6 cases the pain was associated with menses. One presented with gross hematuria. One had no symptoms. Seven out of 8 cases had gynecological diseases and 4 had had surgical treatment for the gynecological diseases. Four patients were treated with gonadotropin-releasing hormone (Gn-RH) analogue for hydronephrosis of endometriosis. In 2 patients, the therapy was effective, but hydronephrosis recurred. Surgical therapy was done on all patients. We recommend surgical therapy for hydronephrosis with ureteral endometriosis.