Women Only Today

I’ve heard the term ‘endometriosis’ tossed around for years and thought I understood what it was. Since I keep exploring anything that might affect the kidneys, I finally started wondering if endometriosis does. Surprise! It does, but only rarely. I found this fascinating.

The logical place to start was the Endometriosis Foundation of America. I was certain I could find a definition of endometriosis there… and I did:

“Endometriosis is not simply a ‘menstruation disease,’ it is a complex systemic disease associated with tissue similar to the endometrial lining of the uterus growing outside the uterus that can affect the whole body.

It is characterized by lesions called implants, nodules, or endometriomas that can respond to monthly fluctuations of hormones (estrogen and progesterone) during the menstrual cycle. During this cycle, estrogen can cause this out-of-place tissue to grow, often causing severe pain. 

Endometriosis is associated with immune and hormonal disruptions. As endometriosis grows, it causes inflammation, which can lead to adhesions, scarring, internal bleeding, bowel or urinary dysfunction, constipation, painful intercourse, or infertility. The physical pain can be severe, which can lead to psychological distress. It’s a combination that, in many ways, can have a debilitating effect on an individual’s life….

Generally, endometriosis is found in the pelvic cavity. It can attach to any female reproductive organs, including the uterus, fallopian tubes, ovaries,  uterosacral ligaments, or peritoneum. It can also affect the bowel, bladder, intestines, appendix, rectum, or leg nerves or settle into spaces between the bladder, rectum, uterus, or vagina. In rare cases, endometriosis can spread outside the pelvic region into the kidneys, lungs, diaphragm, or brain.”

Well, that’s disturbing. How does the endometriosis affect the kidneys? Another site, Endometriosis.net answered my question:

“The kidneys can be impacted when one or both of the ureters become affected by endometriosis. The ureters transport urine from the kidneys to the bladder which stores urine. The section of the ureter that is usually affected sits below the pelvic area…. The involvement of the urinary tract system is uncommon and found in about 1% of endometriosis cases….

Ureteral endometriosis can be limited to one ureter, usually the left side because of the proximity of the left ureter to the reproductive organs.

Endometriosis on the ureter can lead to a urinary tract blockage; Over time, hydronephrosis occurs, which is where the kidney becomes enlarged due to urine failing to drain correctly from the kidneys, and finally, the left kidney may lose function over time….^”

The Seckin MD Medical Center offers this information about other possible causes of kidney endometriosis:

“The exact cause of endometriosis is not clear, and it is even less clear why the condition sometimes affects the kidneys.

Endometrial lesions thicken and shed in response to the ebb and flow of sex hormones during a menstrual cycle. Researchers think that this sometimes leads to the formation of endometrioma or endometrial cysts in the kidneys. However, the exact cause is not clear. Some think that an overactive immune response may play a role in endometrial lesions infiltrating the kidneys.

With each menstrual cycle, more endometrial cysts accumulate in the kidneys. These cysts may invade the renal capsule, or the fibrous layer surrounding the kidneys, and cause pain. Blood clots may block the ureter and lead to renal colic, a type of kidney pain.

As the condition progresses, the endometrial cysts may even distort the shape of the kidneys and interfere with their normal function.”

This is pretty heavy information. I wondered if we’d get any warning if our kidneys were headed this way. Symptoms! We need symptoms for this rare serious disease. Maiden Lane Medical in New York provided just what I was looking for:

“Kidney endometriosis symptoms often feel like endometriosis in general. For example, chronic pelvic pain is the most common symptom. With kidney endometriosis, you may also have low back pain on one or both sides of your body.

 You might also experience:

• Pain in the lower back or legs
• Hematuria (blood in the urine)
• Difficulty urinating
• Recurrent urinary tract infections
• Severe menstrual cramping
• Menstrual cycle abnormalities
• Painful sex
• Pain during urination or bowel movements
• Intestinal pain
• Heavy bleeding or spotting between periods
• Digestive problems

It’s also possible to have no symptoms. Physicians and medical researchers believe that endometriosis often goes undiagnosed either because a person doesn’t experience symptoms or believes their pain is normal.” 

Did you read the part about ‘no symptoms’? How can it be diagnosed with no symptoms? The Cleveland Clinic comes to the rescue with an explanation yet again:

“… the provider (a gynecologist) may start by asking you for your medical history and if any other people in your biological family have endometriosis. They’ll perform a pelvic exam. Then, they may order imaging tests like an ultrasound or MRI….

The only way to definitively diagnose endometriosis is with a laparoscopy. This procedure involves your healthcare provider using a small camera (laparoscope) to look inside your pelvis. Once they see where the tissue is, they can remove a sample of tissue (biopsy) and send it to a lab for testing.

The surgeon will also try to remove or destroy all tissue that is suspicious of endometriosis that they find during this procedure. In this way, a laparoscopy helps with diagnosis and treatment. Sometimes, the location of endometriotic lesions may make it hard to remove without damaging the underlying critical structures. This operation may require an intervention from a team of surgeons such as minimally invasive gynecologists, colorectal surgeons or urologists.

Sometimes, you find endometriosis by accident. Not all people who have endometriosis will experience symptoms. In these cases, your provider might discover the condition during a different procedure.”

We’re coming to the end of today’s blog so let’s skip right over to possible treatments. PubMed Central phrased it succinctly:

“Treatment options vary from active surveillance to thermal ablation, partial or radical nephrectomy depending upon the complexity of the tumour.”

Please keep in mind that kidney endometriosis is rare, but you need to know it exists.

Until next week,

Keep living your life!

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