Bilateral Hydronephrosis Caused by Huge Uterine Myoma

Korean Journal of Nephrology 2007;26(3):373-377.

Ye Ree Park, M.D., Jun Ho Song, M.D., Jeong Hwa Lee, M.D., Shin Ae Park, M.D. Jin Young Kim, M.D., Chul Woo Yang, M.D., Yong Soo Kim, M.D. and Byung Kee Bang, M.D.

Departments of Internal Medicine, Kangnam St. Mary's Hospital The Catholic University of Korea, College of Medicine, Seoul, Korea

거대 자궁근종으로 인한 양측 수신증

박예리 송준호 이정화 박신애 김진영 양철우 김용수 방병기

가톨릭대학교 의과대학 내과학교실

Abstract

A 67-year old woman was admitted due to left femur neck fracture. Pre-operative laboratory data revealed azotemia, and kidney ultrasonogram and pelvis MRI showed bilateral hydronephrosis and huge uterine myoma. On past history, she had uterine myoma since her thirties, but she refused to undergo operation. We initially planned percutaneous nephrostomy (PCN). After stabilization of renal function, we performed subsequent total hysterectomy after insertion of catheters on both ureters, and PCN catheters were removed after confirming that both ureteral catheters worked well. During follow up period of two months after PCN, renal function was gradually improved, but it was not normalized. Size of removed myoma was about 25×15 cm, and histopathologic findings were consistent with leiomyoma. In conclusion, myoma uteri is one of the rare causes of bilateral hydronephrosis, and it may lead to irreversible damage to kidney if left untreated for a long time.

Key Words: Myoma, Hydronephrosis, Chronic renal failure