Ilea C, Lupaşcu Ivona, Socolov Demetra, Cărăuleanu A
Rev Med Chir Soc Med Nat Iasi. 2015 Jan-Mar;119(1):170-4.
Endometriosis represent the presence and proliferation of functional endometrial-like tissue outside the uterine cavity, and is a chronic, recurrent, debilitating desease, in which kidney implications are rare, but complex.
Evaluation of clinical, imagistic and surgical implications of uretero-hydronephrosis secondary to recurrent pelvic endometriosis.
30 year old patient diagnosed with primary infertility and left ovarian endometriosis (treated with classically conservative surgical procedure), presented acute onset of obstructive urinary symptoms, requiring internal drainage of the upper urinary straight path (Cook probe) for uretero-hydronephrosis grade III. CT and MRI examination reveals the presence of a imprecise pelvic mass incorporating right distal ureter and uretero-bladder ostium.
In this clinical and laboratory context, classic surgery is practicing with right anexectomy and direct right uretero-vesical reimplantation, also with psoas bladder-hitch. Histopathological examination confirmed the presence of recurrent ovarian endometriosis with right distal ureteral invasion.
Recurent endometriosis, although considered a benign condition, often present invasive characters, determining considerable anatomical destructions and severe symptoms.
子宫内膜异位症是指子宫腔外存在并增殖功能性子宫内膜样组织，是一种慢性、复发性、使人衰弱的疾病，其中肾脏受累情况罕见但复杂。
评估复发性盆腔子宫内膜异位症继发输尿管积水的临床、影像学及手术影响。
一名30岁患者，诊断为原发性不孕症及左侧卵巢子宫内膜异位症（接受经典保守性手术治疗），出现急性梗阻性泌尿系统症状，因III级输尿管积水需要对上尿路直行路径进行内引流（库克探针）。CT和MRI检查显示存在一个不明确的盆腔肿块，包绕右侧输尿管远端和输尿管膀胱开口。
在这种临床和实验室背景下，实施了经典手术，包括右侧附件切除术、直接右侧输尿管膀胱再植术以及腰大肌膀胱固定术。组织病理学检查证实存在复发性卵巢子宫内膜异位症伴右侧输尿管远端侵犯。
复发性子宫内膜异位症虽然被认为是一种良性疾病，但常具有侵袭性特征，导致相当程度的解剖结构破坏和严重症状。
