Takeuchi S, Minoura H, Toyoda N, Ichio T, Hirano H, Sugiyama Y
Department of Obstetrics and Gynecology, Mie University School of Medicine, Japan.
J Obstet Gynaecol Res. 1997 Jun;23(3):273-6. doi: 10.1111/j.1447-0756.1997.tb00844.x.
Endometriosis occasionally involves the urinary tract, and a ureteral obstruction from this order constitutes a rare variant with serious consequences. Intrinsic ureteric involvement by endometriosis is an exceedingly rare event. This case report describes intrinsic ureteric involvement by endometriosis. The case involved 47-year-old woman, gravida 4, para 2, who had a 4-year history of dysmenorrhea and hypermenorrhea. An intravenous pyelogram showed a right hydronephrosis. She underwent a total abdominal hysterectomy and a right ureteroureterostomy. A pathologic examination revealed complete obstruction of the right ureter by intrinsic intramural endometriosis. We conclude that because ureteral endometriosis, especially intrinsic endometriosis, is usually silent and results in a high rate of renal loss before recognition, physicians should have a hightened awareness of this uncommon but serious manifestation of endometriosis.
子宫内膜异位症偶尔会累及泌尿系统，由此病症导致的输尿管梗阻是一种罕见的变异情况，会产生严重后果。子宫内膜异位症累及输尿管本身是极为罕见的事件。本病例报告描述了子宫内膜异位症累及输尿管本身的情况。该病例涉及一名47岁女性，孕4产2，有4年痛经和月经过多病史。静脉肾盂造影显示右肾积水。她接受了全腹子宫切除术和右输尿管输尿管吻合术。病理检查显示右侧输尿管被壁内子宫内膜异位症完全梗阻。我们得出结论，由于输尿管子宫内膜异位症，尤其是输尿管本身的子宫内膜异位症通常没有症状，在被发现之前导致肾丧失的发生率很高，医生应该提高对这种子宫内膜异位症罕见但严重表现的认识。
