Pelvic endometriosis and hydroureteronephrosis

Luca Carmignani, Paolo Vercellini, Matteo Spinelli, Eleonora Fontana, Giada Frontino, Luigi Fedele

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Objective: To assess whether routine renal ultrasonography may be recommended in all patients with pelvic endometriosis, in order to avoid silent ureteral involvement of the disease. Design: Retrospective descriptive study. Settings: Tertiary center for the treatment of endometriosis at the Department of Obstetrics and Gynecology of the State University of Milan, Milan, Italy. Patient(s): Seven-hundred-fifty patients with a primary diagnosis of endometriosis, between January 2005 and July 2007. Intervention(s): Routine urinary ultrasound; recording of patient history, signs, and symptoms; gynecologic examination; blood and urinary analyses; magnetic resonance imaging; spiral multislice computerized tomography. Main Outcome Measure(s): Symptoms and signs of ureterohydronephrosis; diagnosis of ureterohydronephrosis. Result(s): Twenty-three patients (3%) of all 750 patients with endometriosis had associated ureterohydronephrosis diagnosed at renal ultrasound. Symptoms secondary to ureteral and renal involvement were present in 10 patients (43.5%); 6 reported lumbar pain (26.1%) and 4 patients (17.4%) had renal colic. Conclusion(s): In our study, the high number (56.5%) of asymptomatic ureteral involvement in patients with known pelvic endometriosis seems to warrant the need for further investigations regarding the possibility to avoid the high percentage of silent renal losses. Unfortunately there appears to be no specific risk factor to allow for early suspicion nor a validated preventive diagnostic and therapeutic program. It remains to be evaluated whether urinary ultrasound ensures a beneficial cost-benefit ratio if employed on a routine basis.

Original languageEnglish
Pages (from-to)1741-1744
Number of pages4
JournalFertility and Sterility
Volume93
Issue number6
DOIs
Publication statusPublished - Apr 2010

Fingerprint

Endometriosis
Kidney
Signs and Symptoms
Ureteral Diseases
Renal Colic
Hospital Obstetrics and Gynecology Department
Spiral Computed Tomography
Gynecology
Italy
Cost-Benefit Analysis
Ultrasonography
Retrospective Studies
Magnetic Resonance Imaging
Outcome Assessment (Health Care)
Pain
Therapeutics

Keywords

  • hydronephrosis
  • lumbar pain
  • Pelvic endometriosis
  • renal colic
  • ultrasound
  • ureteral endometriosis

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Reproductive Medicine

Cite this

Pelvic endometriosis and hydroureteronephrosis. / Carmignani, Luca; Vercellini, Paolo; Spinelli, Matteo; Fontana, Eleonora; Frontino, Giada; Fedele, Luigi.

In: Fertility and Sterility, Vol. 93, No. 6, 04.2010, p. 1741-1744.

Research output: Contribution to journalArticle

Carmignani, Luca ; Vercellini, Paolo ; Spinelli, Matteo ; Fontana, Eleonora ; Frontino, Giada ; Fedele, Luigi. / Pelvic endometriosis and hydroureteronephrosis. In: Fertility and Sterility. 2010 ; Vol. 93, No. 6. pp. 1741-1744.
@article{af414e443e92412c9238179eccb67512,
title = "Pelvic endometriosis and hydroureteronephrosis",
abstract = "Objective: To assess whether routine renal ultrasonography may be recommended in all patients with pelvic endometriosis, in order to avoid silent ureteral involvement of the disease. Design: Retrospective descriptive study. Settings: Tertiary center for the treatment of endometriosis at the Department of Obstetrics and Gynecology of the State University of Milan, Milan, Italy. Patient(s): Seven-hundred-fifty patients with a primary diagnosis of endometriosis, between January 2005 and July 2007. Intervention(s): Routine urinary ultrasound; recording of patient history, signs, and symptoms; gynecologic examination; blood and urinary analyses; magnetic resonance imaging; spiral multislice computerized tomography. Main Outcome Measure(s): Symptoms and signs of ureterohydronephrosis; diagnosis of ureterohydronephrosis. Result(s): Twenty-three patients (3{\%}) of all 750 patients with endometriosis had associated ureterohydronephrosis diagnosed at renal ultrasound. Symptoms secondary to ureteral and renal involvement were present in 10 patients (43.5{\%}); 6 reported lumbar pain (26.1{\%}) and 4 patients (17.4{\%}) had renal colic. Conclusion(s): In our study, the high number (56.5{\%}) of asymptomatic ureteral involvement in patients with known pelvic endometriosis seems to warrant the need for further investigations regarding the possibility to avoid the high percentage of silent renal losses. Unfortunately there appears to be no specific risk factor to allow for early suspicion nor a validated preventive diagnostic and therapeutic program. It remains to be evaluated whether urinary ultrasound ensures a beneficial cost-benefit ratio if employed on a routine basis.",
keywords = "hydronephrosis, lumbar pain, Pelvic endometriosis, renal colic, ultrasound, ureteral endometriosis",
author = "Luca Carmignani and Paolo Vercellini and Matteo Spinelli and Eleonora Fontana and Giada Frontino and Luigi Fedele",
year = "2010",
month = "4",
doi = "10.1016/j.fertnstert.2008.12.038",
language = "English",
volume = "93",
pages = "1741--1744",
journal = "Fertility and Sterility",
issn = "0015-0282",
publisher = "Elsevier Inc.",
number = "6",

}

TY - JOUR

T1 - Pelvic endometriosis and hydroureteronephrosis

AU - Carmignani, Luca

AU - Vercellini, Paolo

AU - Spinelli, Matteo

AU - Fontana, Eleonora

AU - Frontino, Giada

AU - Fedele, Luigi

PY - 2010/4

Y1 - 2010/4

N2 - Objective: To assess whether routine renal ultrasonography may be recommended in all patients with pelvic endometriosis, in order to avoid silent ureteral involvement of the disease. Design: Retrospective descriptive study. Settings: Tertiary center for the treatment of endometriosis at the Department of Obstetrics and Gynecology of the State University of Milan, Milan, Italy. Patient(s): Seven-hundred-fifty patients with a primary diagnosis of endometriosis, between January 2005 and July 2007. Intervention(s): Routine urinary ultrasound; recording of patient history, signs, and symptoms; gynecologic examination; blood and urinary analyses; magnetic resonance imaging; spiral multislice computerized tomography. Main Outcome Measure(s): Symptoms and signs of ureterohydronephrosis; diagnosis of ureterohydronephrosis. Result(s): Twenty-three patients (3%) of all 750 patients with endometriosis had associated ureterohydronephrosis diagnosed at renal ultrasound. Symptoms secondary to ureteral and renal involvement were present in 10 patients (43.5%); 6 reported lumbar pain (26.1%) and 4 patients (17.4%) had renal colic. Conclusion(s): In our study, the high number (56.5%) of asymptomatic ureteral involvement in patients with known pelvic endometriosis seems to warrant the need for further investigations regarding the possibility to avoid the high percentage of silent renal losses. Unfortunately there appears to be no specific risk factor to allow for early suspicion nor a validated preventive diagnostic and therapeutic program. It remains to be evaluated whether urinary ultrasound ensures a beneficial cost-benefit ratio if employed on a routine basis.

AB - Objective: To assess whether routine renal ultrasonography may be recommended in all patients with pelvic endometriosis, in order to avoid silent ureteral involvement of the disease. Design: Retrospective descriptive study. Settings: Tertiary center for the treatment of endometriosis at the Department of Obstetrics and Gynecology of the State University of Milan, Milan, Italy. Patient(s): Seven-hundred-fifty patients with a primary diagnosis of endometriosis, between January 2005 and July 2007. Intervention(s): Routine urinary ultrasound; recording of patient history, signs, and symptoms; gynecologic examination; blood and urinary analyses; magnetic resonance imaging; spiral multislice computerized tomography. Main Outcome Measure(s): Symptoms and signs of ureterohydronephrosis; diagnosis of ureterohydronephrosis. Result(s): Twenty-three patients (3%) of all 750 patients with endometriosis had associated ureterohydronephrosis diagnosed at renal ultrasound. Symptoms secondary to ureteral and renal involvement were present in 10 patients (43.5%); 6 reported lumbar pain (26.1%) and 4 patients (17.4%) had renal colic. Conclusion(s): In our study, the high number (56.5%) of asymptomatic ureteral involvement in patients with known pelvic endometriosis seems to warrant the need for further investigations regarding the possibility to avoid the high percentage of silent renal losses. Unfortunately there appears to be no specific risk factor to allow for early suspicion nor a validated preventive diagnostic and therapeutic program. It remains to be evaluated whether urinary ultrasound ensures a beneficial cost-benefit ratio if employed on a routine basis.

KW - hydronephrosis

KW - lumbar pain

KW - Pelvic endometriosis

KW - renal colic

KW - ultrasound

KW - ureteral endometriosis

UR - http://www.scopus.com/inward/record.url?scp=77949912101&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77949912101&partnerID=8YFLogxK

U2 - 10.1016/j.fertnstert.2008.12.038

DO - 10.1016/j.fertnstert.2008.12.038

M3 - Article

C2 - 19200964

AN - SCOPUS:77949912101

VL - 93

SP - 1741

EP - 1744

JO - Fertility and Sterility

JF - Fertility and Sterility

SN - 0015-0282

IS - 6

ER -