尿管エンドメトリオーシスの1例

A CASE OF URETERAL ENDOMETRIOSIS

　54歳女性。無症候性肉眼的血尿を主訴に当科初診。膀胱鏡検査で右尿管口よりの血尿を確認。排泄性尿路撮影で右仙腸関節部1cm下方に尿管狭窄像あり。右逆行性尿路撮影施行するも不能。尿細胞診異常なし。右尿管狭窄あるいは尿管腫瘍の疑いで手術施行。狭窄部尿管を切除し右尿管膀胱再吻合術を施行した。病理診断は尿管エンドメトリオーシスであつた。本症例は稀な疾患であり，本邦では15例目と思われる。

A 54-year-old female patient visited our clinic for asymptomatic macro-hematuria on September 17, 1983. Urinalysis was negative and cystoscopic examination revealed a normal bladder. 4 days later, the same episode recurred and cystoscopic examination showed bleeding from the right ureteral orifice. IVP revealed right ureteral obstruction 1 cm below right sacroiliac joint. Ureteral catheterization was unsuccessful due to obstruction. Urinary cytology was negative. Because of negative urinalysis and IVP, she was followed-up with the diagnosis of right lower ureteral stenosis.