IMR Press / CEOG / Volume 44 / Issue 4 / DOI: 10.12891/ceog3700.2017

Clinical and Experimental Obstetrics & Gynecology (CEOG) is published by IMR Press from Volume 46 Issue 1 (2019). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.

Open Access Case Report
Endometriosis of the ureteral stump: an entity with severe manifestations
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1 Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
2 Deparment of Urology, IRCCS San Raffaele Scientific Institute, Milan, Italy
3 Deparment of Pathology, IRCCS San Raffaele Scientific Institute, Milan, Italy
Clin. Exp. Obstet. Gynecol. 2017, 44(4), 634–636; https://doi.org/10.12891/ceog3700.2017
Published: 10 August 2017
Abstract
A 50-year-old woman on continuous oral estroprogestin therapy and with a history of endometriosis presented with gross hematuria and right reno-ureteral colic pain. Fifteen years before she had undergone total nephrectomy for loss of function of her right kidney due to an ureteral endometriotic nodule resulting in ureteral obstruction. The ureter had not been removed. For the following 15 years-period she had not manifested symptoms or signs of endometriosis. Although imaging investigations allowed to suspect endometriosis of the ureteral stump, urothelial cancer or carcinoma arising in endometriosis nodule could not be excluded. A laparoscopic hysterosalpingo-oophorectomy with the residual ureteral stump removal was performed. Some endometriotic implants on the ureteral stump wall were histologically detected. Proximal ureterectomy should be recommended in patients affected by ureteral endometriosis with a non-functioning kidney since long-term severe complications could derive from the residual stump. A continuous estroprogestin therapy does not totally prevent these complications.
Keywords
Endometriosis
Estroprogestins
Nephrectomy
Ureteral stump
Ureterectomy
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