Update on the diagnosis and treatment of bladder endometriosis

Abstract

Bladder endometriosis is rare, although the bladder is the urinary tract structure most often affected by this condition. The common clinical manifestations of bladder endometriosis include menouria and urethral and pelvic pain syndrome occurring cyclically. Imaging methods are not conclusive for the definitive diagnosis. Cystoscopy is the most useful diagnostic test with confirmation by histologic study. Treatment must be individualized according to the patient's age, desire for future pregnancies, the severity of the symptoms, the site affected, and whether other organs are involved. Two types of treatment are currently used as follows: medical-hormonal and surgical.

A rare case of successful reproductive outcome after IVF following endometrioma resection in a patient of arcuate uterine anomaly and urinary bladder wall endometrioma in women with primary infertility

“…The presence of cyclic hematuria with these symptoms is considered pathognomonic, yet appearing in only 20~25% of patients when the bladder mucosa is involved. 2 In this case patient was not having any micturion problems or hematuria. For the diagnosis of bladder endometriosis, radiographic imaging can demonstrate the size and location of the mass.…”

“…The estimated prevalence of endometriosis is 3~10% of women between 20 and 45 years of age, and 25~35% of infertile women. 2 Bladder endometriosis is a very rare condition. Since the first case was reported by Judd in 1921, the incidence of bladder involvement occurs in <1% of all endometriosis cases according to several reviews.…”

“…Approximately 50% of patients with bladder endometriosis have a history of gynaecologic or obstetric surgery. 2 It is postulated that disruption of the uterus produces seeding of endometrial tissue and subsequent infiltration of the surrounding bladder, detrusor, and mucosa. 6 Seeding of the endometriotic tissue from an endometrioma to the bladder could occur during surgery.…”

“…The cystoscopic image of endometriosis changes over the menstrual cycle, being larger and more congestive during menstruation. 2 Following cystoscopy, histological confirmation is essential in the diagnosis of bladder endometriosis. The treatment of bladder endometriosis should be decided based on the patient's age, desire for future pregnancies, severity of the clinical symptoms, location of the lesion, and other involved organs.…”

“…1 The common sites of endometriosis are the ovaries, posterior cul-de-sac, posterior broad ligaments, uterosacral ligaments, uterus, and fallopian tubes. 2 Endometriosis with bladder involvement is a rare condition, even though the bladder is the most often affected organ among the urinary tract structures. The incidence of bladder endometriosis is reported to be <1% of all types of endometriosis.…”