Bilateral Moderate Hydroureteronephrosis Due to Uterine Prolapse: Two Case Reports and Review of the Literature

Abstract

Uterine prolapse resulting in hydronephrosis was uncommon. We report two cases of complete uterine prolapse and bilateral moderate hydronephrosis. Case 1, she was admitted due to fever with pyuria. Uterine prolapse was noted by incidental finding. Urine culture showed Escherichia coli. She received total vaginal hysterectomy, which corrected the obstruction and bladder dysfunction. Case 2, she had a history of liver cirrhosis and was denied further operation due to bleeding tendency. Renal echo and intravenous pyelography showed bilateral moderate hydronephrosis with hydroureter in the two cases. Normal renal function was found in the two cases. We suggest early diagnosis and management are necessary in order to prevent renal failure and urinary tract infection.

Procidentia: a reversible cause of hydronephrosis in an 80-year-old woman

“…They also reported the association between serum creatinine levels and hydronephrosis to be limited [3]. Uterovaginal procidentia can present with urinary tract infection, renal failure, or as an incidental finding [4]. Previous reports have recommended early reduction of the prolapse to improve renal function, as well as a lower urinary tract investigation [5].…”

Renal failure secondary to uterine prolapse

“…9 It usually coexists with cystocele, rectocele and enterocele. Pelvic prolapse is extremely common in the female population, and the decisive treatments include surgical and conservative methods.…”

“…5,11 On the other hand, in the case of obstruction removed in the first 48 hours, the GFR recovers totally, but if this period exceeds 12 weeks, minimal or no recovery is observed. 9 In addition, if the obstruction is mild or acute, or the collector system is surrounded by a retroperitoneal tumor or fibrosis, hydronephrosis may not appear.…”

Bilateral Hydronephrosis Secondary to Cystocele

“…3,4 A recently published study determined only 3.1% preoperative bilateral hydronephrosis in women with POP. 5 It is estimated that 4-7% patients with uterine prolapse have obstructive uropathy and the mechanism most likely is direct compression of ureters.…”