Risk factors for irreversible unilateral loss of renal function in patients with deep endometriosis.

Sci Rep

Department of Gynecology. Institute Clinic of Gynecology, Obstetrics and Neonatology, Hospital Clinic of Barcelona. Faculty of Medicine, Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Villarroel St., 170, 08036, Barcelona, Spain.

Published: July 2023

AI Article Synopsis

  • Deep endometriosis (DE) is more severe than other types and can cause serious complications, including total loss of kidney function.
  • A study of 436 patients who had surgery for DE analyzed the differences between those with preserved renal function and those with irreversible renal loss, finding significant risk factors such as infertility and certain radiological signs.
  • Key findings suggest that patients with specific symptoms or imaging results, like intestinal DE and a negative sliding sign, are at higher risk for losing kidney function and should be monitored for potential urinary tract obstruction.

Article Abstract

Deep endometriosis (DE) can be more aggressive than other types of endometriosis, and may even lead to irreversible severe complications such as complete unilateral loss of renal function. We aimed to describe the clinical and radiologic characteristics of DE patients diagnosed with irreversible unilateral loss of renal function due to unilateral ureteral stenosis and evaluate risk factors for developing this loss. This retrospective cohort study included 436 patients who underwent laparoscopic DE surgery. We evaluated two groups of patients according to preserved (Non-Renal Loss Group; n = 421) or irreversible unilateral damaged renal function (Renal Loss Group; n = 15). Preoperative epidemiologic variables, clinical characteristics, radiologic findings and surgical treatments of all the patients were collected. The Renal Loss Group had a higher infertility rate and a higher proportion of asymptomatic patients. The following radiological variables showed statistically significant differences between the two groups: mean endometrioma diameter, the presence of intestinal DE and negative sliding sign. Multivariate analysis showed that infertility, being asymptomatic, having intestinal DE or torus uterinus/uterosacral ligament DE and a negative sliding sign significantly increased the risk of loss of renal function. Therefore, among patients with these clinical and/or radiological variables, severe urinary tract obstruction should be specifically ruled out.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10366200PMC
http://dx.doi.org/10.1038/s41598-023-38728-zDOI Listing

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