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

Abstract

Endometriosis is a common gynecologic disease in women of reproductive age. However, endometriosis within the bladder is rare. We present a rare case of a 38-year-old woman who presented with dysmenorrhea and primary infertility. Transvaginal ultrasonography showed an arcuate bulky adenomyotic uterus and left ovarian cystic mass along with urinary bladder endometrioma. Cystoscopic examination was done and removal of endometrioma was attempted, which failed. Afterwards laparoscopic exploration of abdomen was done and a partial cystectomy was performed and it was confirmed that the mass on the bladder wall was a 3.5 cm endometrioma invading the vesical wall on the final pathologic report. Post-operatively, she underwent in vitro fertilization due to both causes i.e. primary infertility and male factor (severe oligo-asthenospermia) and she conceived. We report this case of a patient with primary infertility and bladder endometriosis which was managed successfully with a surgical approach and briefly review the relevant literature.