magazine of Minimally Invasive Gynecology

Urinary tract involvement in endometriosis includes presence of endometriosis deposits inside or across the bladder, ureters, urethra, or kidney. Urethral lesions may additionally purpose fundamental morbidity as silent loss of renal characteristic is common in these patients. signs and symptoms associated with pelvic endometriosis and/or of urinary involvement maybe regularly nonspecific. The most common findings include menstrual signs, flank pain, gross hematuria, and pelvic mass.

Ureteric obstruction resulting in hydronephrosis is a rare manifestation of ureteric endometriosis. It happens attributable to intrinsic involvement inside the ureteric, or from extrinsic compression of the ureteric with the aid of a pelvic endometrioma. In instances of intrinsic involvement, ectopic endometrial tissue is present within the muscular is propria, lamina propriety or ureteric lumen. In extrinsic instances endometriosis takes place inside the ureteric adventitia and adjoining gentle tissues only. Extrinsic involvement is about 4 instances more not unusual than intrinsic disease.

Deeply infiltrating Endometriosis (DIE) maximum generally invades the rectovaginal space, uterosacral ligaments, bowel or urinary tract. Our case was a DIE because of the bilateral ureteric involvement.

analysis of ureteric endometriosis is elusive and relies closely on scientific suspicion. In our case, affected person complained of hesitancy of maturation commonly at some point of menses that's a instead unusual presentation of ureteric endometriosis. This symptom could be defined by using enlargement of active endometriosis tissue across the ureters. in view that ureteric endometriosis takes place usually with pelvic endometriosis there may be a need for multidisciplinary control. revolutionary ureteric obstruction can be insidious and bilateral compromise of ureters might also ultimately result in renal failure. 30% of patients may have reduced kidney feature on the time of analysis that can bring about silent kidney loss.

scientific and surgical remedy is available for ureteric endometriosis. factors influencing remedy desire consist of patients' age, interest in retaining fertility, severity of signs and presence or absence of ureteric obstruction and its results. medical therapy may be offered to those trying to hold reproductive potential or those with regular renal function and no sizable obstruction. In our case surgical control become decided so that the young girl is relieved of the obstruction and forestalls destiny renal damage. more conservative ureterolysis become done minimizing morbidity associated with surgical treatment. To reduce the risk of ureteric fibrosis a double J stent turned into positioned for 6 weeks. A test IVP after elimination of ureteric stents showed resolution of the obstruction. At 6 months comply with up, the patient is relieved of her signs and symptoms and USG KUB suggests regular pelvic clypeal gadget. She has been advised and suggested to comply with up frequently preserving a vigilant eye on recurrence.