Leiomyomatosis peritonealis disseminata that caused hydroureter in association with deep infiltrating endometriosis

Abstract

42-year-old woman was admitted to our clinic with severe pelvic pain and intermittant constipation. In her surgical history,caesarean section and in 2012 laparoscopic myomectomy was noticed. The myomas had been removed by power morcellation. In preoperative evaluation, bilateral endometriosis and hydrosalpinx, sacrouterine nodules, and myomas in the anterior and posterior side of uterus were seen. During laparoscopy, a lot of myomas both on uterus and sigmoid serosa was found. According to paracitic myoma that lying over the right ureter, hydroureteronephrosis was detected. Culde-sac dissection, multiple myomectomy,bilateral salpingectomy and endometrioma excision, and rectosigmoid shaving were performed. A double-J catheter was placed in the right ureter after removing the myomas. All of the pathological specimens were taken out by ccl vaginal exractor with colpotomy. The final pathology was reported disseminated peritoneal myomatozis. Intra-operative and post-operative complications were not observed in our 6 month follow-up.