Combined transurethral and laparoscopic partial cystectomy for the treatment of bladder endometriosis
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20170597Keywords:
Bladder, Endometriosis, Laparoscopy, Partial cystectomy, TransurethralAbstract
We present a case of a 22-year-old nulliparous woman, initially investigated by a urologist after she presented with a history of urinary tract symptoms including catamenial hematuria and suprapubic pain. Ultrasonographic and cystoscopic findings suggested a bladder mass suspicious for endometriosis. Further MRI revealed a 3 X 4 cm mass in the bladder, and the diagnosis of endometriosis was confirmed by the biopsy. Consequently, the patient was offered treatment options including combined laparoscopic and transurethral resection of the bladder lesion for definitive diagnosis and treatment. Using a combination of hydrodissection and CO2 laser energy laparoscopically and monopolar electro-surgery cystoscopically, the lesion was resected uneventfully and the bladder defect was repaired laparoscopically. The patient was discharged on the same day with a Foley catheter, which was removed 10 days later. After 8 weeks follow up period, she remained free of symptoms. Histopathology confirmed endometriosis. We conclude that this combined approach is feasible, safe and effective therapy for intramural bladder endometriosis.
References
Sener A, Chew B, Duvdevani M, Brock G, Vilos G, Pautler S. Combined transurethral and laparoscopic partial cystectomy and robot-assisted bladder repair for the treatment of bladder endometrioma. J Minim Invasive Gynecol. 2006;13(3):245-8.
Maccagnano C, Pellucchi F, Rocchini L, Ghezzi M, Scattoni V, Montorsi F et al. Diagnosis and treatment of bladder endometriosis: State of the Art. Urol Int. 2012;89(3):249-58.
Bogart L, Berry S, Clemens J. Symptoms of interstitial cystitis, painful bladder syndrome and similar diseases in women: a systematic review. J Urol. 2007;177(2):450-6.
Vilos G, Vilos A, Abu-Rafea B, Hollett-Caines J, Nikkhah-Abyaneh Z, Edris F. Three simple steps during closed laparoscopic entry may minimize major injuries. Surg Endosc. 2008;23(4):758-64.
Missmer SCramer D. The epidemiology of endometriosis. Obstet Gynecol Clin North Am. 2003;30(1):1-19.
Tirlapur S, Daniels J, Khan K. Chronic pelvic pain. Curr Opin Obstet Gynecol. 2015;27(6):445-8.
Mettler L, Gaikwad V, Riebe B, Schollmeyer T. Bladder Endometriosis: Possibility of Treatment by Laparoscopy. JSLS. 2008;12:162-5.
Balleyguier C, Chapron C, Dubuisson J, Kinkel K, Fauconnier A, Vieira M, et al. Comparison of Magnetic Resonance Imaging and Transvaginal Ultrasonography in Diagnosing Bladder Endometriosis. J Am Assoc Gynecol Laparosc. 2002;9(1):15-23.
Walid MHeaton R. Laparoscopic partial cystectomy for bladder endometriosis. Arch Gynecol Obstet. 2008;280(1):131-5.
Chapron C , Dubuisson JB , Jacob S , Fauconnier A , Da Costa Vieira M. Laparoscopy and bladder endometriosis. Gynecologie, Obstetrique and Fertilite. 2000;28(3):232-7.