尿管エンドメトリオーシスの2例

概要

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We report two successfully treated cases of ureteral endometriosis. Case 1 is in a 47-year-old female who had a past history of simple hysterectomy and right oophorectomy. Pathological diagnosis was myoma uteri and pelvic endometriosis. Two months later, she visited our clinic for right flank pain. Excretory urogram and retrograde pyelogram revealed right hydroureteronephrosis and stricture of the right lower ureter. The diagnosis of ureteral endometriosis was made from the past history and clinical features. Danazol therapy started with a daily dose of 400 mg. Sixteen days later, excretory urogram demonstrated complete resolution of the right hydronephrosis. An intravenous pyelography about 1 year after the danazol therapy has indicated no recurrence. Case 2 is in a 35-year-old female who visited our clinic for right lumbar pain. Excretory urogram and retrograde pyelogram revealed right hydroureteronephrosis and stricture of the right lower ureter. Right ureterocystoneostomy was performed unsuccessfully resulting in endoscopic dilation. Right lower ureter was buried in the dense fibrous tissue approximately 5 cm below the crossing with iliac vessels. The area of obstruction was removed. Histologically, endometriosis was diagnosed. Twenty nine cases of ureteral endometriosis including our two cases were collected from the Japanese literatures and reviewed with respect to the clinical features and treatment.