BACKGROUND: Endometriosis is a chronic and benign condition in which endometrial glands and stroma are present outside the uterine cavity. The pathogenesis of endometriosis is not fully understood; however, several mechanisms have been hypothesized. Endometriosis is a common clinical presentation in gynecology, but affecting the urinary tract is a rare phenomenon, occurring in 0.3–12% of cases. In more severe forms, the initial presentation may be hydronephrosis or infertility.

CASE REPORT: We describe the case of a 25-year-old Saudi woman who presented with obstructive urinary tract symptoms and was diagnosed with urinary bladder endometriosis complicated with a right hydronephrosis. After thorough investigations and workups, the management was taken on by a multidisciplinary team approach.

CONCLUSIONS: This case report shows that hormonal therapy management resulted in a satisfactory outcome contrary to the surgical resection approach that is discussed in many articles.

Keywords: Contraceptives, Oral, Hormonal, Endometriosis, Hydronephrosis, Uterine Diseases, Urinary Bladder Diseases