Mitsuzuka Koji, Suzuki Kenichi, Takeuchi Mutsuo
Department of Urology, Iwaki Kyoritsu General Hospital.
Hinyokika Kiyo. 2002 May;48(5):297-300.
We report a case of intrinsic-type ureteral endometriosis in a 28-year-old woman. She visited our hospital, complaining of lower abdominal pain. Drip infusion pyelography (DIP) showed left hydronephrosis, and left retrograde pyelography revealed a filling defect of the left pelvic ureter. Biopsy under ureteroscopy showed chronic ureteritis. It was difficult to exclude a malignant tumor, and we performed left partial ureterectomy and uretero-ureterostomy. The pathological examination showed endometrial tissue in the submucosal and muscle layer, and we diagnosed it as intrinsic-type ureteral endometriosis judging from the findings of the ureteroscopy and the operation. After the operation, drip infusion pyelography showed the improvement of the left hydronephrosis and ureteral passage, and the right ovarian endometriosis was found by gynecologists. She received hormonal therapy with the luteinizing hormone releasing hormone agonist for about half a year, but the right ovarian endometriosis remained unchanged. This is the ninth case in the Japanese literature reported as intrinsic-type ureteral endometriosis.
我们报告一例28岁女性的内在型输尿管子宫内膜异位症。她因下腹部疼痛前来我院就诊。静脉肾盂造影(DIP)显示左肾积水,左逆行肾盂造影显示左盆腔输尿管有充盈缺损。输尿管镜检查活检显示为慢性输尿管炎。难以排除恶性肿瘤,遂行左半输尿管切除术及输尿管输尿管吻合术。病理检查显示黏膜下层和肌层有子宫内膜组织,根据输尿管镜检查及手术结果,诊断为内在型输尿管子宫内膜异位症。术后,静脉肾盂造影显示左肾积水及输尿管通畅情况有所改善,妇科医生发现右侧卵巢子宫内膜异位症。她接受促黄体生成素释放激素激动剂激素治疗约半年,但右侧卵巢子宫内膜异位症无变化。这是日本文献报道的第九例内在型输尿管子宫内膜异位症病例。