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Arterial hypertension as an inaugural sign of myomatous uterus
  1. Tânia Ascensão1,
  2. Helena Barros Leite2,
  3. Sidónio Matias2 and
  4. Fernanda Águas2
  1. 1Department of Obstetrics and Gynecology, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal
  2. 2Department of Gynecology, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal
  1. Correspondence to Dr Tânia Ascensão; tania.ascensao0802{at}


Uterine fibroids can be large enough to cause mechanical obstruction of pelvic ureters, which may result in hydroureters and hydronephrosis. Renal impairment frequently results in hypertension due to increased activity of the tubuloglomerular feedback system and renin–angiotensin–aldosterone axis. This process, however, seems reversible because normalisation of blood pressure is possible after the relief of renal obstruction. We report a rare case of a nulliparous woman with a myomatous uterus and an isolated initial complaint of high blood pressure. After proper diagnostic investigation, a uterine mass of 20 cm causing bilateral hydronephrosis was discovered. A successful myomectomy was conducted, which achieved an intact endometrium lining with posterior normalisation of blood pressure.

  • ultrasonography
  • obstetrics
  • gynaecology and fertility
  • renal system
  • urinary and genital tract disorders
  • reproductive medicine

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  • Contributors TA was involved in the conception, designing, data collection and drafting of the article. HBL contributed to the drafting and revision of the the case. SM contributed to patient clinical management and revision of the the case. FA contributed both to the drafting of the case and to the final revision and approval of the version published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.