title: Silent onset of postmenopausal endometriosis in a woman with renal failure in hormone replacement therapy: a case report.
abstract: BACKGROUND
  Postmenopausal endometriosis is a rare form of a common disease, since the absence of estrogenic hormone production should halt disease progression.
  
  
  METHODS
  We present the case of a 54-year-old Italian Caucasian woman in surgical menopause with a history of ovarian endometriosis, who underwent voluntary hormone replacement therapy for seven years. She developed postrenal renal failure due to bilateral compression of the pelvic ureteral tract caused by two large, deeply infiltrating endometriotic nodules with no pelvic pain. She underwent operative laparoscopy with adhesiolysis of enteroenteric adhesions and excision of the endometriotic nodules encompassing the juxtavesical tract of the ureters, without obtaining improvement of renal failure.
  
  
  CONCLUSIONS
  Postmenopausal endometriosis can manifest itself in an unpredictable and potentially very serious manner. It is therefore important to carefully evaluate the risks and benefits of administering hormone replacement therapy to patients with previous endometriosis.
authors.affiliation: Maternal-Child Department, Operative Unit of Obstetrics and Gynecology, ULSS 17 - Veneto, Monselice (PD), Italy. ugo.indraccolo@libero.it.
authors.forename: Ugo
authors.initials: U
authors.lastname: Indraccolo
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Barbieri