Can endometriosis cause hydronephrosis?

Yes. Endometriosis can cause hydronephrosis when it affects the ureter (the tube that drains urine from the kidney to the bladder) and narrows or compresses it, causing urine to back up into the kidney. This is most often related to deep endometriosis and may happen with or without obvious urinary symptoms.

This can be tricky because kidney bloodwork and routine urine tests can be normal even when there’s meaningful obstruction. Symptoms may look more like pelvic pain, flank or back discomfort, or unexplained urinary irritation than a classic kidney problem. Imaging typically raises the concern (often ultrasound, CT urography, or MRI) because it can show hydronephrosis and help map whether endometriosis is near the ureter or bladder.

Because hydronephrosis can threaten kidney function over time, our team takes urinary tract involvement seriously and plans evaluation and surgery around the whole picture, rather than pelvic pain alone. If you’ve had imaging that mentions hydronephrosis or ureteral narrowing and you suspect endometriosis, you can reach out to schedule a consultation so we can review your symptoms and records and talk through next steps.