Complete loss of unilateral renal function secondary to endometriosis: a report of three cases

• Published in: European journal of obstetrics & gynecology and reproductive biology Vol. 171; no. 1; pp. 132 - 137
• Main Authors: Arrieta Bretón, Sara, López Carrasco, Ana, Hernández Gutiérrez, Alicia, Rodríguez González, Roberto, de Santiago García, Javier
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01-11-2013
• Subjects: Adult; Endometriosis - complications; Endometriosis - surgery; Female; Humans; Hydronephrosis - etiology; Hydronephrosis - surgery; Kidney Failure, Chronic - etiology; Magnetic Resonance Imaging; Middle Aged; Nephrectomy; Obstetrics and Gynecology; Obstructive uropathy; Radionuclide Imaging; Renal function loss; Treatment Outcome; Ultrasonography; Ureter - surgery; Ureteral Diseases - complications; Ureteral Diseases - surgery; Ureteral endometriosis; Ureteral Obstruction - etiology; Ureteral Obstruction - surgery; Urinary Tract - diagnostic imaging; Ureteral endometriosis; Renal function loss; Nephrectomy; Obstructive uropathy
• ISSN: 0301-2115; 1872-7654
• DOI: 10.1016/j.ejogrb.2013.08.022

Abstract Objectives To report the impact that urinary tract endometriosis may have on renal function. Ureteral endometriosis is an uncommon and silent cause of renal injury. It is therefore very important to be highly suspicious in order to be able to make an early diagnosis and thus prevent renal failure. Study design Case reports of the management and outcome of three cases of premenopausal women with deep endometriosis affecting the ureter, associated with secondary unilateral complete loss of renal function. Results and conclusions Ureteral involvement by endometriosis is a rare and often silent disease which is capable of producing significant morbidity, as it can lead to hydronephrosis and ultimately to renal failure. Because of the lack of specific symptoms and the limitations of imaging methods, a high index of suspicion is necessary to obtain an early diagnosis. On diagnosis of deep infiltrating endometriosis, urinary tract ultrasound is a screening tool to detect ureterohydronephrosis due to ureteral obstruction. MRI is of value to map the extent of disease. Surgery is the treatment of choice to remove endometriotic lesions and relieve ureteral obstruction if the kidney is still functional, or to perform a nephrectomy if there is a complete loss of renal function.