Laparoscopic Surgery for Bladder Endometriosis: A Case Report

Katsuya Mine, Shigeo Akira, Yukihiro Kondo, Toshiyuki Takeshita
In: Nihon Ika Daigaku Igakkai Zasshi · 2010 · vol. 6(3) , pp. 147–151 · doi:10.1272/manms.6.147 · W1993540408
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A 33-year-old woman with bladder endometriosis and an ovarian cyst underwent laparoscopic partial cystectomy, achieving complete resolution of cyclic pain without complications.

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This case report describes the management of a 33-year-old woman presenting with cyclic bladder pain associated with menstruation. Despite inconclusive biopsy results showing only chronic cystitis, clinicians diagnosed bladder endometriosis based on characteristic clinical findings and imaging that also revealed an ovarian endometrial cyst. The patient underwent laparoscopic partial cystectomy combined with resection of the ovarian cyst, resulting in complete symptom resolution within four weeks without complications. This paper is centrally about endometriosis — specifically the surgical treatment of deep infiltrating lesions involving the bladder wall.

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Abstract

A 33-year-old woman was referred to us by the department of urology because of cyclic bladder pain during menstruation. Cystoscopy showed a 3.5-cm-diameter tumor in the bladder mucosa, and a biopsy showed chronic cystitis. Transvaginal ultrasound and pelvic magnetic resonance imaging revealed a left endometrial ovarian cyst. Although a biopsy did not prove bladder endometriosis, we diagnosed bladder endometriosis on the basis of the characteristic clinical findings. Laparoscopic partial cystectomy for bladder endometriosis and left ovarian endometrial cyst resection were performed. The bladder was closed in one layer using Z sutures with #3-0 polyglactin 910. Indigo carmine dye was then used to check for any leakage. The procedure lasted 4 hours, and the estimated blood loss was 10mL. There were no technique problems or complications. The Foley catheter was removed after 7 days. The symptoms had resolved by 4 weeks after surgery, and the patient was released to routine follow-up. The patient had complete resolution of bladder symptoms and cyclic pelvic pain and was delighted with the absence of pain and the cosmetic result.
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症例から学ぶ 腹腔鏡下手術を施行した膀胱子宮内膜症―診断と治療のポイント 2010 年 6 巻 3 号 p. 147-151 詳細 抄録 A 33-year-old woman was referred to us by the department of urology because of cyclic bladder pain during menstruation. Cystoscopy showed a 3.5-cm-diameter tumor in the bladder mucosa, and a biopsy showed chronic cystitis. Transvaginal ultrasound and pelvic magnetic resonance imaging revealed a left endometrial ovarian cyst. Although a biopsy did not prove bladder endometriosis, we diagnosed bladder endometriosis on the basis of the characteristic clinical findings. Laparoscopic partial cystectomy for bladder endometriosis and left ovarian endometrial cyst resection were performed. The bladder was closed in one layer using Z sutures with #3-0 polyglactin 910. Indigo carmine dye was then used to check for any leakage. The procedure lasted 4 hours, and the estimated blood loss was 10mL. There were no technique problems or complications. The Foley catheter was removed after 7 days. The symptoms had resolved by 4 weeks after surgery, and the patient was released to routine follow-up. The patient had complete resolution of bladder symptoms and cyclic pelvic pain and was delighted with the absence of pain and the cosmetic result. © 2010 日本医科大学医学会

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