Female Menstrual Cup Causing Renal Colic, Hydronephrosis, and Ureteral Stricture: A Case Report.

INTRODUCTION: Renal colic is a common reason for patients to present to the emergency department (ED). The most common reasons for this pain are usually renal in origin. Here we present the case of a 45-year-old woman with severe right-sided flank pain and associated hydronephrosis secondary to ureteral obstruction caused by the suction of a menstrual cup. CASE REPORT: A 45-year-old female presented to the ED with sudden severe right-sided flank pain. The patient endorsed nausea without vomiting, fever, chills, hematuria, or dysuria. She stated that she was currently having her menstrual period. On physical exam, the patient was in distress but had no tenderness with palpation of the flank or abdomen. A computed tomography of the kidneys, ureters, and bladder did not show renal or ureteral stones but demonstrated right-sided hydronephrosis secondary to an anatomical blockage of the ureter, which had been suctioned and involuted into a malpositioned menstrual cup. The patient removed her menstrual cup and had immediate relief of her symptoms. She was observed and remained completely asymptomatic upon reassessment two hours later. CONCLUSION: Ureteral obstruction and hydronephrosis is a rare complication of menstrual cup use. As these devices become more common, emergency physicians must be aware of this complication as a cause of severe back pain in menstruating women.