title: Complete loss of unilateral renal function secondary to endometriosis: a report of three cases.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  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.
authors.affiliation: Department of Obstetrics and Gynecology, La Paz University Hospital, Madrid, Spain. Electronic address: saraarrietabreton@gmail.com.
authors.forename: Sara
authors.initials: S
authors.lastname: Arrieta Bretón
authors.forename: Ana
authors.initials: A
authors.lastname: López Carrasco
authors.forename: Alicia
authors.initials: A
authors.lastname: Hernández Gutiérrez
authors.forename: Roberto
authors.initials: R
authors.lastname: Rodríguez González
authors.forename: Javier
authors.initials: J
authors.lastname: de Santiago García
mesh_terms: D000328:Adult; D004715:Endometriosis / Q000150:complications* / Q000601:surgery; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000209:etiology / Q000601:surgery; D007676:Kidney Failure, Chronic / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011877:Radionuclide Imaging; D016896:Treatment Outcome; D014463:Ultrasonography; D014513:Ureter / Q000601:surgery; D014515:Ureteral Diseases / Q000150:complications* / Q000601:surgery; D014517:Ureteral Obstruction / Q000209:etiology / Q000601:surgery; D014551:Urinary Tract / Q000000981:diagnostic imaging
keywords: Nephrectomy; Obstructive uropathy; Renal function loss; Ureteral endometriosis