A 55-year-old woman with complete uterovaginal prolapse has bilateral flank pain and fever. Ultrasound reveals bilateral hydronephrosis. The hydronephrosis in this setting is most likely due to:

• A Ureteric calculus
• B Pelvic kidney
• C Ureteric kinking by the prolapsed uterus ✓
• D Retroperitoneal fibrosis

Explanation

Severe genital prolapse can cause bilateral hydronephrosis due to mechanical kinking of the ureters at the pelvic brim by the prolapsed uterus. This is a known complication of long-standing third-degree uterovaginal prolapse. Relief of the prolapse typically reverses the hydronephrosis. This is distinct from obstruction by calculi or pelvic kidney, which are unrelated to prolapse.

Reference: Shaw's Textbook of Gynaecology, 18th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.