A 35 Y lady presented with left flank pain since - 3 months. She had h/o hysterectomy with rt oophorectomy 6 y ago and ? left ovarian cystectomy/ oophorectomy 6m ago. Physical examination was normal. On evaluation there was left hydroureteronephrosis on USG. CTIVU revealed left lower ureteric obstruction. Diuretic Renogram revealed partial obstruction in the drainage of left kidney, with decreased relative function. She was planned for Left RGP and proceed. On RGP - there was splaying of lower ureter, which did not fillup initially of left lower ureter. Diagnostic ureteroscopy was normal. DJ stent kept. Further plan is to get FSH, CA 125 and sos medical menagement and USG guided aspiration. If this fails she will need surgical exploration and excision of cyst/release of ureter from adhesions.
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| USG showing left hydronephrosis |
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| CTIVU showing obstruction of midureter due to cystic lesion |
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| CTIVU showing obstruction of midureter due to cystic lesion |
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| CTIVU showing obstruction of midureter due to cystic lesion |
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| CTIVU showing obstruction of midureter due to cystic lesion |
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| Diuretic renogram confirming obstruction and impaired renal function |
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| Diuretic renogram confirming obstruction and impaired renal function |
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Left RGP showing HDUN due to splaying of ureter in the pelvis
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Thanks for sharing the report on the ovarian remnant causing lower ureter obstruction.
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