Complications Related to Urinary Tract Endometriosis (UTE)

Urinary tract endometriosis (UTE) is a rare form of deep infiltrating endometriosis (DIE). In UTE, endometrial tissue growths can occur either superficially or deep inside organs of the urinary tract such as the bladder, ureters, and kidneys.

UTE affects around 0.3% and 12% of women with endometriosis and between 20% and 52.6% among those diagnosed with DIE. Approximately 85% of UTE cases occur in the bladder. Ureteral endometriosis accounts for 10%, kidney endometriosis for 4%, and urethral endometriosis for 2% of cases.

No symptoms mean the disease can stay undiagnosed for a long time

Nearly 50% of UTE cases, particularly of the ureter, are asymptomatic. UTE on the peritoneum that does not grow deep into the bladder can still cause pain when having a full bladder or when passing urine. This pain is usually indistinguishable from the one caused due to other kinds of peritoneal endometriosis.

In some cases women with UTE may experience:

• pelvic pain
• dysuria (pain with urination)
• dyspareunia (painful intercourse)
• recurring urinary tract infections
• changes to urination frequency
• hematuria (blood in the urine)
• urinary incontinence

UTE needs to be diagnosed and treated urgently

Most gynecologists often fail to properly identify UTE even when symptoms are present. This leads to significant delays in confirmed diagnosis that varies between 6 to 12 years.

Laparoscopic excision surgery followed by histological examination is the gold standard for confirming endometriosis in the urinary tract. Only a surgeon who is well-qualified and understands all aspects of endometriosis can identify and confirm the presence of UTE.

Getting this done early is paramount because UTE can impact nerves that control vital functions of the bladder, vagina, and bowels. The disease can obstruct the free passage of urine from the kidneys to the bladder via the ureter. This can result in hydroureter (swelling and dilation of ureters due to downstream blockage) or hydronephrosis (enlargement of kidneys). These can lead to severe back pain, increased blood pressure, and potential kidney failure.

Excision surgery is the gold standard to treat UTE

Surgical treatment is the best option to completely remove all endometriosis lesions in the urinary tract and prevent them from recurring.

Laparoscopic deep excision surgery can help remove endometriosis lesions in the urinary tract and preserve renal function.

The team at Seckin Endometriosis Center, with their vast expertise in laparoscopic excision surgery and a multi-disciplinary approach that puts the patient at the center of all decision making, is able to isolate and remove all forms of endometriosis, including the deep infiltrating forms. This approach provides long-lasting relief resulting in a vastly improved overall quality of life.

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