title: Silent loss of kidney seconary to ureteral endometriosis.
abstract: BACKGROUND
  Ureteral endometriosis is a serious localization of disease burden that can lead to urinary tract obstruction, with subsequent hydroureter, hydronephrosis, and potential kidney loss. Diagnosis is elusive and relies heavily on clinical suspicion as ureteral endometriosis  can occur with both minimal and extensive disease. Surgical technique to treatment varies, but the goal is to salvage renal function and decrease disease burden.
  
  
  METHODS
  We describe 3 cases in which there was documentation of renal atrophy and function loss with subsequent  workup and surgical intervention.
  
  
  RESULTS
  The cases illustrate varying surgical approaches tailored to localization of ureteral endometriosis. All cases were carried out laparoscopically.
  
  
  CONCLUSIONS
  Ureteral endometriosis, albeit rare, can be complicated by potential  loss of renal function. Clinical suspicion and preoperative assessment may help with diagnosis and allows for a multidisciplinary preconsultation. Laparoscopic surgical approach is based on extent of disease and localization and can be carried out successfully in the hands of a highly experienced  laparoscopic surgeon.
authors: Center for Special Minimally Invasive Surgery, Stanford University Medical Center, Palo Alto, CA 94304, USA. cnezhat@stanford.edu
authors: Camran
authors: C
authors: Nezhat
authors: Chandhana
authors: C
authors: Paka
authors: Mona
authors: M
authors: Gomaa
authors: Erica
authors: E
authors: Schipper
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D004715:Endometriosis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000209:etiology / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008279:Magnetic Resonance Imaging; D009392:Nephrectomy; D014057:Tomography, X-Ray Computed; D014513:Ureter; D014515:Ureteral Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery*