Can endometriosis cause hydronephrosis?

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

What makes this tricky is that kidney bloodwork and routine urine tests can be normal even when there’s meaningful obstruction, and symptoms may look more like pelvic pain, flank/back discomfort, or “mystery” urinary irritation than a classic kidney problem. Imaging is typically what 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 builds evaluation and surgical planning around the whole picture, not just the pelvic pain. 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.