Bilateral ureteric obstruction of a partially duplicated collecting system improves after surgical correction of procidentia: a case report.
BACKGROUND
Although the association between pelvic organ prolapse and upper urinary tract dilation has been documented, the causal relationship between the two has not been established. We report an improvement in severe hydronephrosis and hydroureter of a partially duplicated urinary collecting system after surgical correction of procidentia.


METHODS
A 52-year-old woman presented with radiologic evidence of a partially duplicated right collecting system with right-sided hydronephrosis and bilateral hydroureter in the setting of stage IV uterovaginal prolapse. A therapeutic trial of pessary placement failed to resolve the upper urinary tract dilation. The patient underwent abdominal hysterectomy, bilateral salpingo-oophorectomy, sacrocolpopexy, mid-urethral sling placement and posterior colporrhaphy. Repeat intravenous urography 4 weeks after surgery demonstrated interval resolution of the hydronephrosis.


CONCLUSIONS
An improvement in hydronephrosis after surgical correction supports a cause-and-effect relationship between pelvic organ prolapse and obstructive uropathy.
White
Amanda B
AB
Division of Urogynecology/Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX 75390-9032, USA.
Wai
Clifford Y
CY
Marinis
Spyridon I
SI
Schaffer
Joseph I
JI
D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D008875:Middle Aged; D014517:Ureteral Obstruction / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D014596:Uterine Prolapse / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*