Urinary tract endometriosis (UTE) occurs when endometrial-like tissue grows on or within the organs of the urinary tract. The bladder is the most commonly affected area, followed by the ureters, and rarely the urethra or kidneys. It affects approximately 1% to 12% of women with endometriosis.Key SymptomsSymptoms frequently overlap with recurrent Urinary Tract Infections (UTIs) or interstitial cystitis, often causing significant diagnostic delays. Common indicators include:Cyclic pain: Pelvic pain, cramping, or burning during urination that intensifies just before or during menstruation.Urinary changes: Increased urinary frequency, urgency, or difficulty emptying the bladder.Hematuria: Visible blood in the urine, specifically during your period.Flank/Loin pain: Can occur if endometriosis nodules compress the ureters, blocking urine flow from the kidneys.CausesWhile the exact cause is unknown, theories include retrograde menstruation (where tissue flows backward into the pelvis) and iatrogenic spread, where endometrial cells implant during prior pelvic surgeries like a cesarean section.DiagnosisBecause superficial lesions are often missed on standard scans, diagnosis requires specialized investigation by experienced sonographers, gynecologists, or urologists. Diagnostic methods include:Magnetic Resonance Imaging (MRI): Considered the study of choice to visualize all components of the urinary tract and deep pelvic lesions.Transvaginal Ultrasound: High-resolution imaging can accurately detect deep infiltrating endometriosis nodules on the bladder or ureters when performed by a specialist.
