Bilateral extrinsic endometriosis of the ureters with renal failure: A case report

Ureteral involvement in endometriosis is usually overlooked because it complicates less than 0.5% of cases and remains asymptomatic in the majority. Despite its rarity, ureteral endometriosis is important because the consequent irreversible renal damage may cause considerable morbidity. A case of chronic renal failure caused by bilateral extrinsic endometriosis is described. The patient presented with acute abdominal pain prior to the planned radical surgical procedure. She did not complain of menstrual dysfunction or urinary symptoms. Bilateral adnexal masses and the sensory loss of pelvic nerve compression were found on physical examination. Incidental routine investigations showed deranged renal function and obstructive uropathy. Ureterolysis, bilateral salpingooophorectomy and subtotal hysterectomy successfully relieved the obstruction. The potential existence of ureteral endometriosis should be realized. Vigilance in performing surgery offers the best chance of cure.