title: Ureteral obstruction associated with pelvic inflammatory disease in a long-term intrauterine contraceptive device user.
abstract: We report herein a case of ureteral obstruction associated with pelvic inflammatory disease in a long-term intrauterine contraceptive device (IUD) user. A 62-year-old woman presented with a 2-week history of left flank pain and high fever, but no abdominal pain. She had forgotten the use of an IUD. Retrograde pyelography showed a stricture in the lower third of the left ureter. Magnetic resonance showed swelling of the uterus wall and left parametria, but did not reveal the presence of an IUD. Subtotal hysterectomy, bilateral salpingo-oophorectomy and left nephronureterectomy was performed. The IUD was then found in the uterine cavity. The results of pathological and bacteriological findings for Actinomyces infection were negative. Therefore we diagnosed this case as ureteral obstruction associated with pelvic inflammatory disease. Ureteral obstruction associated with pelvic inflammatory disease in a long-term IUD user is extremely rare.
authors.affiliation: Department of Urology, Mie University School of Medicine, Mie, Japan. amikurumika@yahoo.co.jp
authors.forename: Shigenori
authors.initials: S
authors.lastname: Yonemura
authors.forename: Mitsuhiko
authors.initials: M
authors.lastname: Moriya
authors.forename: Yasuhide
authors.initials: Y
authors.lastname: Hori
authors.forename: Kiminobu
authors.initials: K
authors.lastname: Arima
authors.forename: Nagayasu
authors.initials: N
authors.lastname: Toyoda
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Sugimura
mesh_terms: D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy; D007434:Intrauterine Devices / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009392:Nephrectomy; D000292:Pelvic Inflammatory Disease / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D013997:Time Factors; D014517:Ureteral Obstruction / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D014567:Urography