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Background <p>Urinary tract endometriosis (UTE) is a rare manifestation of deep infiltrating endometriosis (DIE) and is often underdiagnosed due to nonspecific or absent urinary symptoms. Delayed recognition may result in progressive ureteric obstruction and silent renal function loss. This study aimed to evaluate the incidence, clinical presentation, imaging findings, surgical management, and outcomes of patients with UTE managed at a tertiary referral center.</p> Methods <p>A retrospective observational study was conducted at GEM Hospital, Coimbatore, between January 2020 and December 2025. Among 496 women evaluated for endometriosis, 12 patients diagnosed with UTE were included. Demographic details, clinical features, magnetic resonance imaging (MRI) findings, intraoperative observations, surgical procedures, and postoperative outcomes were analyzed. Surgical management was individualized and included laparoscopic ureterolysis, ureteric stenting or reimplantation, bladder lesion excision, or segmental bladder resection.</p> Results <p>The mean age was 38.75 ± 6.29&#xa0;years. Ureteric involvement was observed in seven patients (58%) and bladder involvement in five (42%). Dysmenorrhea was the most common symptom (66%), while one patient was asymptomatic. MRI identified hydroureteronephrosis in all ureteric cases, predominantly due to extrinsic compression. Laparoscopic ureterolysis successfully relieved obstruction in most patients. Definitive surgery was performed in nine patients, while fertility-preserving procedures were done in three. All patients were symptom-free at follow-up, with no major complications.</p> Conclusion <p>UTE, though rare, carries a significant risk of silent renal damage. Early clinical suspicion, MRI-based evaluation, and timely multidisciplinary laparoscopic management are crucial for renal preservation and favorable outcomes.</p>

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The Silent Kidney—Unmasking the Urinary Tract Involvement in Endometriosis—An Observational Study at a Tertiary Care Hospital

  • 期刊论文

  • 发表日期：

    2026年6月26日

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  • Kavitha Yogini Duraiswamy,
  • Kanchibhotla Meghana,
  • Sai Dharshini,
  • G. Vishnu Priya

摘要

Background

Urinary tract endometriosis (UTE) is a rare manifestation of deep infiltrating endometriosis (DIE) and is often underdiagnosed due to nonspecific or absent urinary symptoms. Delayed recognition may result in progressive ureteric obstruction and silent renal function loss. This study aimed to evaluate the incidence, clinical presentation, imaging findings, surgical management, and outcomes of patients with UTE managed at a tertiary referral center.

Methods

A retrospective observational study was conducted at GEM Hospital, Coimbatore, between January 2020 and December 2025. Among 496 women evaluated for endometriosis, 12 patients diagnosed with UTE were included. Demographic details, clinical features, magnetic resonance imaging (MRI) findings, intraoperative observations, surgical procedures, and postoperative outcomes were analyzed. Surgical management was individualized and included laparoscopic ureterolysis, ureteric stenting or reimplantation, bladder lesion excision, or segmental bladder resection.

Results

The mean age was 38.75 ± 6.29 years. Ureteric involvement was observed in seven patients (58%) and bladder involvement in five (42%). Dysmenorrhea was the most common symptom (66%), while one patient was asymptomatic. MRI identified hydroureteronephrosis in all ureteric cases, predominantly due to extrinsic compression. Laparoscopic ureterolysis successfully relieved obstruction in most patients. Definitive surgery was performed in nine patients, while fertility-preserving procedures were done in three. All patients were symptom-free at follow-up, with no major complications.

Conclusion

UTE, though rare, carries a significant risk of silent renal damage. Early clinical suspicion, MRI-based evaluation, and timely multidisciplinary laparoscopic management are crucial for renal preservation and favorable outcomes.