Untreated uterine fibroids may cause serious kidney damage, according to the African Rural Doctors Association.

The doctors revealed this in a detailed medical explainer, which says large fibroids can block the normal flow of urine, leading to kidney injury and even chronic kidney disease in the long term if left untreated.

How it happens

According to the doctors, although fibroids begin in the uterus and although small growths are not stated to cause kidney injuries, it is mentioned that very large fibroids can affect nearby organs, including the urinary system, by pressing on the ureters. This can trigger hydronephrosis.

“Hydronephrosis is an abnormal backup of urine into the kidneys due to a pathological blockage of the urine outflow pathway into the bladder for storage and excretion.

“Conditions such as kidney stones and strictures/scars along the intrinsic pathway often prevent urine outflow, causing dilated and tortuous engorgement of ureters and enlargement of the kidneys with destruction of the functional units of the kidneys (Nephrons). Both neoplastic and benign tumours outside the kidneys can apply external pressure that prevents urine drainage, with consequent backups that stretch, enlarge and destroy the functional units of the kidneys….”

Case study

To illustrate the dangers of delayed treatment, the African Rural Doctors Association, led by Senior Medical Director / Co-founder: Dr Mark Adjetey Abban MD, MBChB, cited the case of a 36-year-old woman who sought medical attention after waking with severe pain in her right side.

According to the doctors, she had previously experienced similar episodes that were initially thought to be appendicitis. Further assessment, however, revealed symptoms including heavy menstrual bleeding, painful menstruation, urinary frequency, bladder pressure and infertility.

An emergency ultrasound later revealed multiple uterine fibroids and hydronephrosis affecting both kidneys, with significant damage to the outer layer of her right kidney.

Diagnosis

Doctors diagnosed her with right renal cortical atrophy, shrinkage of part of the kidney caused by prolonged hydronephrosis after the fibroids obstructed urine flow.

She underwent emergency treatment to drain urine from the affected kidney before later having surgery to remove her uterus while preserving her ovaries. According to the doctors, the procedure significantly improved her kidney function.

Dr Mark Adjetey Abban urged women of childbearing age to undergo regular gynaecological assessments for early detection and treatment of fibroids to prevent complications affecting the kidneys, fertility and overall health.

"Fibroids themselves do not kill, but associated comorbid complications can seriously affect quality of life and disease outcomes," he said.