Bladder Endometriosis: Diagnostic, Therapy, and Outcome of a Single-Center Experience.

Background/

Objectives

Endometriosis is a benign condition affecting up to 10% of women at reproductive age. The urinary tract is affected in 0.3-12.0% of women with endometriosis and in 19.0-53.0% of women with deep infiltrating endometriosis. The bladder is the most commonly affected organ in the urinary tract. Bladder endometriosis is defined by the presence of endometriosis lesions in the detrusor muscle, with partial or complete thickness involvement.

Methods

This was a retrospective study. The study analyzed surgical reports of 11,714 patients who underwent endometriosis laparoscopy, and included only 42 patients with bladder endometriosis.

Results

We found that 0.35% of patients with endometriosis had bladder endometriosis. In total, 29 patients underwent phone follow-up. In total, 26 patients (90%) reported a general improvement in their symptoms (e.g., improving the dysmenorrhea, lower abdominal pain), with a 100% improvement in their dysuria. Only two patients (7%) reported no change in symptoms (dysmenorrhea and dyspareunia).

Conclusions

Gynecologists can perform laparoscopic surgical treatment of bladder endometriosis in most cases. If ureteroneocystostomy is required or the localization of the endometriosis nodule is unfavorable, an intervention by an interdisciplinary team is recommended. Both laparoscopic partial bladder resection and shaving can be considered effective methods with low complication risk. This surgical approach requires excellent laparoscopic skills.