Bladder endometriosis treated by laparoscopic partial cystectomy: our approach (original) (raw)
Related papers
International journal of reproduction, contraception, obstetrics and gynecology, 2017
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.
Laparoscopic Partial Cystectomy for Bladder Endometriosis
Journal of Minimally Invasive Gynecology, 2010
Laparoscopic partial cystectomy performed for bladder endometriosis in selected patients requires advanced laparoscopic skills including pelvic dissection, suturing and intracorporeal knot tying. Cystoscopic skills to assess the extent of endometriosis involvement in the bladder and to place ureteral stents if endometriosis involves or is close to the trigone, ureters, or projected course of the intramural part of the ureter are also required. Previous authors have recommended the laparoscopic technique only with bladder endometriosis that is distant from the bladder neck, the ureteral oriWces, and the trigone, to allow a resection margin of 1-2 cm. We Wnd no reason to exclude patients with these involvements if the surgeon can safely do the resection and reconstruction. We report a 32-year-old patient referred by her urologist for the evaluation and treatment of biopsyproven bladder endometriosis penetrating the bladder wall and mucosa above and to the right of the midline of the trigone approximately 1.5 in. in diameter with Wbrotic scarring extending to the trigone and very close to the right ureteral oriWce. The patient successfully underwent partial laparoscopic cystectomy as described in the body of the paper.
A Case of Primary Bladder Endometriosis Who Had Undergone Partial
2016
Primary bladder endometriosis is rare. Most cases are secondary to pelvic surgery, such as cesarean section or hysterectomy. In this article, we present a case of primary bladder endometriosis in a 33 year-old female patient who had undergone partial cystectomy. Hematuria which is not related to menstruel cycle, and pelvic pain were initial complaints of the patient. After a transurethral resection at an external center where the patient received definitive diagnosis, complaints of the patient had stood still post-operatively. We have decided to perform an open partial cystectomy after cystoscopic and radiological re-evaluation of the patient in our clinic. A 20 mm diameter solid mass extending out of the bladder was excised at the operation. No endometriotic lesions were detected in pelvic peritoneum or ovaries. At the follow-up, there were no recurrences both at cystoscopy and computerised tomography for 4 months after the surgery.
Fertility and Sterility, 2008
Objective: To report the successful management of bladder endometriosis with laparoscopic and transurethral partial cystectomy. Design: Case report. Setting: Tertiary-care university hospital. Patient(s): A 36-year-old woman with bladder endometriosis. Intervention(s): Combined laparoscopic and transurethral excision of endometriotic lesions and bladder repair. Main Outcome Measure(s): Symptoms remission. Result(s): A hypoestrogenic agent with gonadotropin-releasing hormone (GnRH) agonist was administered for 6 months after the surgery. The patient found to be in good health with normal voiding and full continence during 14 months of regular follow-up evaluations. Conclusion(s): Combined laparoscopy and transurethral resectoscopy can be an alternative treatment to traditional laparotomy in women with bladder endometriosis, especially in those who have simultaneous pelvic endometriosis. (Fertil Steril Ò 2008;90:2014.e1-e3.
Cystoscopy-Assisted Laparoscopic Resection of Extramucosal Bladder Endometriosis
Journal of Endourology, 2002
Background and Purpose: Involvement of the bladder is seen in only 1% to 2% of patients with endometriosis. The diagnosis of vesical endometriosis is difficult to formulate, and it should be confirmed by cystoscopy with biopsy. However, this examination is often insufficient because of the submucosal-transmural location of the lesion. Therefore, laparoscopic examination represents the gold standard for the diagnosis of pelvic endometriosis. We describe a case of recurrent bladder endometriosis treated by a combined endoscopy technique. Case Report: A 43-year-old woman presented with pelvic pain, dysmenorrhea, and persistent cystitis. The endometriotic lesion on the posterior wall of the bladder consisted in a 2.5-cm nodule growing into the vesical muscularis and raising the overlying peritoneum. We performed laparoscopic resection employing a cystoscopy-assisted technique in order to preserve the integrity of the vesical mucosa. Resection was carried out and monitored from inside the bladder with the cystoscope and laparoscope lights turned on during the whole procedure ("light-to-light" technique). Conclusion: This minimally invasive combined endoscopic procedure could represent a good alternative to partial cystectomy for muscle-infiltrating bladder endometriosis that does not involve the vesical mucosa.
Standard Approach to Urinary Bladder Endometriosis
Journal of minimally invasive gynecology, 2017
Urinary endometriosis accounts for 1% of all endometriosis where the bladder is the most affected organ. Although the laparoscopic removal of bladder endometriosis has been demonstrated to be effective in terms of symptom relief with a low recurrence rate, there is no standardized technique. Partial cystectomy allows the complete removal of the disease and is associated with low intra- and postoperative complications. Here we describe a stepwise approach to a rare case of a large endometriosis nodule affecting the trigone of the urinary bladder. Step-by-step video explanation of a large endometriotic nodule excision (Canadian Task Force classification III). IRCAD AMITS - Barretos | Hospital Pio XVI. The video was approved by the local institutional review board. A 31-year-old woman. Laparoscopic approach for bladder endometriosis. We present a case of a 31-year-old woman who complained of dysuria and hematuria with a bladder nodule of 3 cm affecting the bladder trigone. Laparoscopic...
Fertility and Sterility, 2010
Objective: To evaluate surgical outcome and long-term follow-up of conservative laparoscopic management of urinary tract endometriosis (UTE). Design: Prospective study. Setting: Tertiary-care university hospital. Patient(s): Women with laparoscopic diagnosis and histologic confirmation of urinary bladder or ureteral endometriosis who agreed to undergo long-term follow-up after laparoscopic management. Intervention(s): (1) Laparoscopic partial cystectomy for bladder endometriosis.