Urinary tract endometriosis: enigmas in diagnosis and management

The diagnosis and management of endometriosis presents several enigmas. This review, of eight patients with endometriosis involving the urinary tract, from three large clinical services in the City of Los Angeles, highlights some very difficult problems. Not only diagnostic errors but also inappropriate conservatism and inadequate surveillance have led to compromised function, resection, and/or destruction of the kidneys, ureters, or bladder. The series indicates those findings which are likely to result in urinary tract destruction and points out those clinical situations in which delays or conservative management must be undertaken only with pressing indications and then only with continued and careful surveillance.