Most common locations for endometriosis in the urinary tract:
(1) trigone of the bladder
(2) dorsal wall of the bladder
(3) ureterovesical junction
(4) distal third of the ureter
The lesions appear as reddish, brown or bluish nodules with a friable surface. Long standing lesions may show adjacent fibrosis. Fibrosis around the distal ureter can result in hydroureter.
Reasons to suspect endometriosis of the urinary tract:
(1) presence of endometriosis elsewhere
(2) long-term pain in the pelvis, lower back or flank
(3) dysuria or other problems with urination
(4) rarely hematuria
(5) hydroureter with or without hydropelvis or hydronephrosis
(6) palpable mass on bimanual vaginal palpation
Differential diagnosis:
(1) benign or malignant tumor
(2) lithiasis
(3) congenital malformation
