Kurobe Masahiro, Kojima Takahiro, Uchida Masahiro, Miyagawa Tomoaki, Tsutsumi Masakazu, Sugita Shintaro
The Department of Urology, Hitachi General Hospital.
Hinyokika Kiyo. 2012 Jul;58(7):329-33.
Ureteral endometriosis is a rare but important clinical problem that requires early detection and treatment. The urinary tract is affected in approximately 2% of women with endometriosis. Even though the bladder is the most frequent urinary tract organ affected in these patients,the ureter is also affected in 10-40% of the cases, thus requiring immediate clinical attention. The majority of endometrial lesions is typically located in the lower segment of the ureter and is often difficult to differentiate between endometriosis and malignancy. Ureteral endmetriosis should be considered for women with hydronephrosis. In this report we present one clinical case of mixed-type ureteral endometriosis. A 37-year-old woman was referred to our hospital due to left hydronephrosis. Contrast-enhanced CT scan confirmed left hydronephrosis and also showed a solid mass at the left lower ureter. Retrograde pyelography revealed stenosis of the left lower ureter and Renogram revealed severely impaired renal function. Laparoscopic nephroureterectomy was performed. Pathologically, mixed-type endometriosis of the left ureter was diagnosed.
输尿管子宫内膜异位症是一个罕见但重要的临床问题,需要早期发现和治疗。在大约2%的子宫内膜异位症女性中,泌尿道会受到影响。尽管膀胱是这些患者中最常受影响的泌尿道器官,但输尿管在10%至40%的病例中也会受到影响,因此需要立即引起临床关注。大多数子宫内膜病变通常位于输尿管下段,且往往难以区分子宫内膜异位症和恶性肿瘤。对于肾积水的女性应考虑输尿管子宫内膜异位症。在本报告中,我们展示了一例混合型输尿管子宫内膜异位症的临床病例。一名37岁女性因左肾积水转诊至我院。增强CT扫描证实左肾积水,并显示左输尿管下段有一个实性肿块。逆行肾盂造影显示左输尿管下段狭窄,肾图显示肾功能严重受损。实施了腹腔镜肾输尿管切除术。病理诊断为左输尿管混合型子宫内膜异位症。