Obstructive uropathy associated with primary ureteral endometrioma: case report and review of the literature
Bibliographic record
Abstract
We report the case of a 56-year-old postmenopausal woman whopresented with incidental left hydronephrosis during an investigationfor a gastrointestinal complaint. The patient denied any historyof flank pain or hematuria. Contrast-enhanced computedtomography revealed severe right-sided ureterohydronephrosis aswell as renal atrophy. The contralateral kidney was normal, as wasthe patient’s overall renal function. A retrograde ureterogramdemonstrated complete ureteral obstruction 4 cm proximal to theureterovesical junction. Subsequent ureteroscopy revealed a polypoidmass completely occupying the ureteral lumen, of which thebiopsies demonstrated inconclusive atypical urothelial changes.The patient underwent a laparoscopic nephrectomy with opendissection of the distal ureter. The patient recovered well postoperatively.Final pathology revealed a benign obstructingendometrioma without evidence of invasion from periureteraltissue. This appears to be the first reported case of asymptomaticprimary ureteral endometrioma with secondary renal atrophy.Earlier investigation and treatment may have allowed for renalpreservation earlier in the course of the disease.Nous décrivons le cas d’une femme ménopausée de 56 ans présentantune hydronéphrose gauche découverte de façon fortuite aucours d’un examen mené pour donner suite à des symptômes gastro-intestinaux. La patiente n’avait pas d’antécédents de douleurau flanc ou d’hématurie. Une TDM avec agent de contraste arévélé une urétéro-hydronéphrose droite importante accompagnéed’une atrophie rénale. Le rein controlatéral et la fonction rénaleglobale de la patiente ne présentaient aucune anomalie. Uneurétérographie par voie rétrograde a permis d’observer une obstructioncomplète de l’uretère proximale à 4 cm de la jonction urétérovésicale.Une urétéroscopie subséquente a révélé une masse polypoïdeoccupant la totalité de la lumière urétérale et des analysesaprès biopsie ont montré des changements atypiques non concluantsau niveau de l’épithélium urinaire. La patiente a subi unenéphrectomie par laparoscopie avec dissection ouverte de l’uretèredistale. La patiente s’est bien rétablie après l’intervention. Lerapport final de pathologie a révélé un endométriome obstructifbénin sans signe d’invasion des tissus péri-urétéraux. Il sembleque ce soit ici le premier cas signalé d’endométriome urétéralprimitif asymptomatique avec atrophie rénale secondaire. Un examenet un traitement réalisés plus tôt dans le cours de l’évolutionde la maladie auraient pu permettre la préservation du rein.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.006 | 0.005 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".