Endometriosis: The Effects on Urological morbidity(*)

Posted by Chantel Martiromo, Research article by Kyle J. Norton

During the last stage of the menstrual cycle, normally a layer of endometriosis lining on the inside of the uterus is expelled, known as menstruation blood, instead some of the endometriosis tissues grow somewhere in the body to cause endometriosis. Endometriosis also react to hormone signals of the monthly menstrual cycle, by building and breaking up tissues and eliminating them through menstrual period.

The Affects on Urological morbidity(*)
1. Irregular and painful urination
Normally irregular urination in adults is caused by pressure of a fetus on the bladder of a pregnant woman or losing muscle of the badder causing the feeling to use the bathroom. In woman with endometriosis, irregular and painful urination are caused by endometrial implants or adhesion in the badder region, which increases the pressure to the urinary system resulting in irregular urination(77)(78)(81).

2. Lower bdominal pain on urination
Lower abdominal pain may be caused by endometrial implants, adhesion or cysts in the pelvic region or by over-production of prostaglandins which increases the tension of muscle spam in the bowel and the uterus. Lower abdominal pain on urination is caused by over-production of prostaglandins which stimulate the contraction of the ovaries and uterus muscles or endometrial implants and adhesion in the lower abdominal area causing pressure and pain on urination(77).

3. Blood in urine
Blood in urine is a common cause of women with endometrial implants or cysts attached to the bladder area as resulting of bleeding of the endometriosis. It worsens just before and during menstruation(77).

4. Kidney dysfunction
Kidney dysfunctiopn may be caused by the weakened immune system of woman with endometrial adhesion attached to the kidney causing abnormal function of the kidney and kidney fluid retention. It may be caused by cysts in the pelvic region which increases pressure of the bladder and urinary tract resulting in mounting pressure to the kidney, causing kidney tenderness. It worsens at the beginning and during period(79)(80).

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References
(*)Incidence of pre- and postoperative urinary dysfunction associated with deep infiltrating endometriosis: relevance of urodynamic tests and therapeutic implications by Bonneau C¹, Zilberman S, Ballester M, Thomin A, Thomassin-Naggara I, Bazot M, Daraï E.(PubMed)
(77) Visceral syndrome in endometriosis patients by Hansen KE¹, Kesmodel US², Baldursson EB³, Kold M⁴, Forman A².(PubMed)
(78)Innovations in conservative endometriosis treatment: an updated review by Ruhland B¹, Agic A, Krampe J, Diedrich K, Hornung D.(PubMed)
(79) Ureteral endometriosis: a rare and underdiagnosed cause of kidney dysfunction by Ponticelli C¹, Graziani G, Montanari E.(PubMed)
(80) Ureteral endometriosis: a rare and underdiagnosed cause of kidney dysfunction by Ponticelli C¹, Graziani G, Montanari E.(PubMed)
(81)Urinary incontinence and bladder endometriosis: conservative management by Leone Roberti Maggiore U¹, Ferrero S, Salvatore S.(PubMed)