Uterine fibroids are most commonly known for symptoms like heavy periods and pelvic pain. But these noncancerous growths can also be the cause of a kidney condition called hydronephrosis, according to a study in the Journal of Obstetrics and Gynaecology.1
“While most women with fibroids don’t get hydronephrosis, a small percentage of women with very large fibroids develop the condition,” explains Dr. Alex Shteynshlyuger, Board-Certified Urologist, Urological Surgeon, and Director of Urology at New York Urology Specialists in New York City, NY, who was not involved in the study. “Hydronephrosis is caused by blockage of the ureters—or the tubes that carry urine from the kidneys to the bladder—due to pressure exerted by fibroids. When urine can’t drain properly, this causes the kidneys to swell. Hydronephrosis caused by fibroids requires prompt treatment, as it can cause damage to the kidneys.”
Just how common is uterine fibroid-related hydronephrosis? A team of researchers at the University of West Indies Hospital in Kingston, Jamaica, conducted a retrospective study that looked into the causes and severity of kidney impairment.1 In a group of 1,274 women with impaired kidney function, case notes for 160 of these women were analyzed and 8.1% (13 women) were found to have uterine fibroids.
The researchers then looked at a second group of 216 women who all had fibroids diagnosed by ultrasound.1 Of these women, 14% (31 women) had hydronephrosis, caused by fibroids. In comparison to those in the group without hydronephrosis, kidney function was similar except for blood urea levels (a type of waste that’s passed from the body in the urine) were significantly worse in women with fibroid-related hydronephrosis. It was concluded that fibroids can cause kidney damage, but the prognosis appeared to be good.
But in order for a woman with fibroid-related hydronephrosis to have a positive outcome, she needs swift and adequate medical attention. “When it comes to hydronephrosis caused by fibroids, urologists and gynecologists are involved in treatment,” Dr. Shteynshlyuger says. “Short-term treatment involves putting a small plastic tube called a ‘stent’ in the ureter to allow urine to pass from the kidneys to the bladder. Long term, the fibroids require treatment.”
Symptoms of hydronephrosis may be slow and insidious and can manifest as flank or back pain and discomfort—or there may be no symptoms at all. Dr. Shteynshlyuger explains that the disease can develop slowly. As it progresses, other symptoms can include visible blood in the urine, frequent urination or difficulty urinating. If these symptoms appear, visiting your doctor is advised. Urine tests can also show if microscopic blood is in the urine. Kidney function can be checked by a blood test that looks at levels of serum creatinine or Cystatin C.
“Most women with small fibroids need not worry, as small fibroids are unlikely to cause any significant problems,” Dr. Shteynshlyuger continues. “Women with large fibroids especially those that cause other symptoms such as pain, abdominal distension or discomfort need to be checked annually. Usually pelvic ultrasound can detect large fibroids. And kidney ultrasound can be performed if there is a concern about hydronephrosis.”
ABOUT THE AUTHOR Alicia Armeli is a Health Freelance Writer and Editor, Registered Dietitian Nutritionist, and Certified Holistic Life Coach, and a paid consultant of Merit Medical. She has master’s degrees in English Education and Nutrition. Through her writing, she empowers readers to live optimally by building awareness surrounding issues that impact health and wellbeing. In addition to writing, she enjoys singing, traveling abroad and volunteering in her community.
ABOUT THE DOCTOR Alex Shteynshlyuger, MD is a board-certified urologist, urological surgeon, and Director of Urology at New York Urology Specialists in New York City, NY. Providing both surgical and urological care, Dr. Shteynshlyuger is one of the few fellowship-trained urologists in the US. He also has had sub-specialty training in Minimally Invasive Urologic Oncology. Leading a versatile practice, Dr. Shteynshlyuger sees patients in his office, as well as major hospitals in the area and accredited ambulatory surgical centers. Treating both men and women with complex urological conditions, he provides care management tailored to each patient.
- Fletcher, H., Wharfe, G., Williams, N., et al. (2013). Renal impairment as a complication of uterine fibroids: a retrospective hospital-based study. J Obstet Gynaecol, May; 33(4): 394-398.