Can endometriosis surgery injure the ureter or bladder?

Yes—ureter or bladder injury is a known (but uncommon) risk in endometriosis surgery, especially when disease is deep, scarred in, or directly involving the urinary tract. Endometriosis can pull the ureter and bladder out of their usual anatomic planes, and dense fibrosis can make these structures harder to identify and safely separate.

In advanced cases, the ureter may need to be carefully dissected free (ureterolysis) to restore normal anatomy and protect kidney drainage, and bladder endometriosis sometimes requires precise excision from the bladder wall. That’s why surgical planning matters: mapping disease on imaging when possible, anticipating urinary-tract involvement, and using meticulous technique to identify and protect the ureters and bladder throughout the operation.

In our practice, we use robotic excision for its magnified 3‑D optics and wristed instruments, which can improve visualization and precision around delicate structures like ureters and the bladder. If you’re worried about urinary-tract risks in your specific case—especially if you have urinary symptoms, prior surgery, or suspected deep disease—reach out to our team for an individualized surgical plan and risk review.