Bladder Endometriosis

Evaluation of the clinical and surgical outcomes in women who underwent surgical treatment for rare bladder endometriosis

Key Points

Highlights:

• Laparoscopic partial cystectomy and shaving of the bladder lesion are the methods used to improve urinary symptoms, complication and recurrence rate is low, and long-term bladder capacity not affected.

Importance:

• Urinary tract endometriosis is rare, especially with nonspecific symptoms making it difficult to diagnose.

What’s done here?

• A retrospective review of data from 10 patients who underwent surgical treatment for bowel endometriosis between the years 2012-2016 is presented.
• The data analyzed included pre- and postoperative information, intraoperative findings, type of surgical procedure, and intra- and postoperative complications.

Key results:

• 2 of the 10 patients studied underwent laparoscopic shaving of the bladder lesion, and 8 underwent laparoscopic partial cystectomy.
• Only 1 intra-operative complication and no postoperative complications were reported in these 10 cases.
• Clinical symptoms of all 10 showed improvement, with only 1 case of urinary symptom recurrence.

Limitations of the study:

• The sample size is low for drawing accurate conclusions.
• Recurrence rate was calculated from the 4-year data available. We cannot exclude the possibility of long term recurrence.

Lay Summary

Bladder endometriosis is rare – about 1-2% of women with endometriosis may have endometrial lesions in their urinary tract. Diagnosis of bladder endometriosis is difficult because of its nonspecific symptoms such as frequent urination, pelvic pain, and burning sensation when urinating, which are also symptoms of ever so common cystitis.

This recent study by Gonçalves et al., published in "Surgical Technology International" in March 2019 analyzed the available data from patients with bladder endometriosis with a goal of understanding the clinical and surgical outcomes in women who underwent surgical treatment for bladder endometriosis.

The authors retrospectively reviewed pre- and postoperative data, intraoperative findings, type of surgical procedure, and intra- and postoperative complications from a total of 10 patients. The number of cases studied is low, however, given the rarity of bladder endometriosis, results are worth discussing here.

Findings from this retrospective study showed that bladder endometriosis could be treated in two ways: laparoscopic shaving of the bladder lesion or laparoscopic partial cystectomy (removing the affected part of the bladder).

Among the 10 patients studied, 2 underwent laparoscopic shaving of the bladder lesion and 8 underwent laparoscopic partial cystectomy. Overall, only one intraoperative complication and no major or minor postoperative complications were noted. Clinical symptoms were reported to be improved and only in one case recurrence was observed within the 4 years the study covered. However, long term recurrence is still a possibility. 

This surgical approach requires an experienced gynecologist and urologist team specified in endometriosis.

Research Source: https://www.ncbi.nlm.nih.gov/pubmed/30888677