URETERAL ENDOMETRIOSIS DIAGNOSED AT URETEROSCOPY

Background: Intrinsic ureteral endometriosis is rare. Early detection and treatment is extremely important to preserve renal function. Case: A 37-year-old woman with right flank pain was diagnosed with a polypo id lesion at excretory urogram. The polyp was removed under ureterosco py and was found to be endometriosis. Subsequent exploratory laparotom y and ureterolysis failed to document other foci of endometriosis. Res ection of the ureter was not needed. She received medroxyprogesterone for 6 months, and a ureteral stent was left in place for 3 months post operatively. Excretory urogram showed no obstruction 6 months postoper atively. Conclusion: This appears to be the first reported case of ure teral endometriosis documented initially at ureteroscopy. Prompt treat ment may relieve symptoms and preserve renal function. Resection of th e ureter may be avoided in some patients. (C) 1998 by The American Col lege of Obstetricians and Gynecologists.