尿管子宮内膜症

Abstract

We present a case of ureteral endometriosis in a 48-year-old postmenopausal patient who was hospitalized complaining of right flank pain & microhematuria. She had no bladder irritability. She had a past history of simple hysterectomy and left oophorectomy because of adenomyomatosis. At that time, right ovary and other pelvic organs were normal. Physical examination revealed slight swelling of the liver without tenderness. Laboratory data at admission revealed severe liver dysfunction due to liver cirrhosis. Excretory urography demonstrated right hydronephroureterosis and severe stricture of the right lower ureter. Right ureteral catheterization demonstrated a high degree of stricture at the distal third. Cytology of right pelvic urine was negative. Right nephroureterectomy was done because long segment of right lower ureter adhered to the peritoneum tightly and we could not rule out ureteral cancer. Pathological diagnosis was extrinsic endometriosis of the right ureter. Ureteral endometriosis is rare and postmenopausal endometriosis is also rare. In our case hyperestrogenemia caused by liver cirrhosis might have played a role in the genesis and progression of endometriosis.