Urinary tract Endometriosis
Endometriosis can involve all peritoneal surfaces, including the pelvic sidewalls near the ureters and on the bladder flap peritoneum overlying the bladder. Usually only the peritoneal surface is involved. Endometriosis starts superficial and then invades progressively deeper into the underlying tissues. If there is endometriosis/fibrosis into the pelvic sidewalls by the vessels and ureters or deep in the pelvis near the bladder or rectal wall, then that is no problem since that is what I do every week and it is what people travel here for. Depending on the situation, there are times I will excise rectal or bladder endometriosis (partial or full-thickness) and laparoscopically suture repair the rectum or bladder. If there is disease invading a ureter (less than 1% of cases), I do not manage ureteral involvement and I would wake you up and refer you to another center.