There are no official guidelines to assist in answering this question. I will search for relevant research papers instead.
From the Research
Endometriosis in the Kidneys
- Endometriosis is a common benign condition in women of reproductive age, characterized by the presence of endometrial glands and stroma outside the uterine cavity, which can affect either genital or extragenital sites 1.
- Involvement of the urinary tract is rare, and among the urinary tract endometriosis, only a few cases involve the kidney 1, 2.
- Renal endometriosis is extremely rare and can be difficult to diagnose, with a final diagnosis relying on pathohistologic findings 1, 2, 3.
Symptoms and Diagnosis
- Symptoms of renal endometriosis can be non-specific, and the disease may be clinically silent or associated with intermittent flank pain, abdominal pain, or gross hematuria 1, 4, 3.
- Imaging studies, such as CT or MRI, can reveal contracted non-functioning kidneys or perinephric abscesses, but may not always detect endometriosis 1, 2.
- A high index of suspicion and radiological support are necessary for an early diagnosis, and in some cases, ureteroscopy or laparoscopy may be required 4.
Treatment and Prognosis
- Treatment of renal endometriosis involves hormonal manipulation or surgery, such as nephrectomy or laparoscopic surgery, depending on the level of renal function and the extent of the disease 1, 4.
- The prognosis of ureteral endometriosis depends on the time of diagnosis, and early detection is crucial to prevent advanced, irreversible renal failure 4.
- In some cases, patients may benefit from progestin or anti-aromatase therapy, but surgery is often necessary to relieve symptoms and prevent further complications 4.