Right hydronephrosis due to asymptomatic ureteral endometriosis: A case report

Rationale: Endometriosis involves uterine glands and endometrial tissue outside the uterus, with ureteral invasion being rare and often asymptomatic. Accurate diagnosis relies on multimodal ultrasound (abdominal, transvaginal, and contrast-enhanced) and ultrasound-guided transvaginal posterior puncture biopsy. Patient concerns: A 40-year-old premenopausal female was admitted for elevated blood pressure, with no urologic symptoms. Diagnoses: Abdominal computed tomography indicated right hydronephrosis and a right distal ureteral occupying lesion. Combined abdominal-transvaginal ultrasound, contrast-enhanced ultrasound, and biopsy confirmed ureteral endometriosis. Interventions: Multimodal ultrasound (abdominal, transvaginal, and contrast-enhanced) and ultrasound-guided transvaginal posterior puncture biopsy were performed for diagnosis. Outcomes: Rapid and definitive diagnosis was achieved, enabling timely intervention to prevent disease progression. Lessons: For premenopausal women with asymptomatic hydronephrosis and ureteral stenosis, general ultrasound combined with contrast-enhanced ultrasound and biopsy allows rapid, definitive diagnosis, preventing disease progression.