[Urological complications of endometriosis].
Endometriosis (E) of the urinary tract is often not diagnosed at the beginning of the disease, particularly in cases with bladder wall involvement resulting in persistent dysuria and pelvic pain. Therefore, cystitis-like symptoms in younger women without evidence of urinary tract infections should be considered to be caused by E. Characteristic endoscopic findings may be missed and deep transurethral resection may be necessary for harvesting endometriotic tissue. This situation and improvement of diagnosis by ultrasound are demonstrated by a case report. The development of endometrial polyps in the uterus after tamoxifen (TAM) management is a well-known side effect of this antiestrogenic therapy. We observed a woman with endometrial polyps in the bladder after TAM. Endometriotic ureter stenosis in the absence of colics or other symptoms may results in irreversible loss of kidney function. Verification of the diagnosis is a common task of urology and gynecology. In three of six cases treated in our institution within 5 years, E of the ureter was first ascertained by the presence of ureter damage following surgical treatment of E. In two cases bowel E was present at the same time. Conservative treatment by suppression of ovarian function in most cases of stenosis of the ureter does not avoid the need for subsequent resection and reimplantation because of persistent fibrosis of the ureter wall.
Klinik für Urologie und Kinderurologie, Klinikum Deggendorf. urologie@klinikum-deggendorf.de
P E
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Carl
D000328:Adult; D003558:Cystoscopy; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging; D004715:Endometriosis / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D005260:Female; D052776:Female Urogenital Diseases / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D006801:Humans; D007674:Kidney Diseases / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D010535:Laparoscopy; D008875:Middle Aged; D011127:Polyps / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D011230:Precancerous Conditions / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D014513:Ureter / Q000473:pathology / Q000601:surgery; D014517:Ureteral Obstruction / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D001743:Urinary Bladder / Q000473:pathology / Q000601:surgery; D001745:Urinary Bladder Diseases / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery