Combined Transurethral and Laparoscopic Partial Cystectomy and Robotically Assisted Bladder Repair for the Treatment of Bladder Endocervicosis: Case Report and Review of the Literature

Rajakumar C, Chandrew Rajakumar, Vilos GA, George A. Vilos, Angelos G. Vilos, Vilos AG, Jennifer Marks, Marks JL, Jennifer L Marks, Helen C. Ettler, Ettler HC, Stephen Pautler, Stephen S Pautler, Pautler SS
Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC · 2014 · vol. 36(2) , pp. 141–145 · doi:10.1016/s1701-2163(15)30660-5 · PMID:24518913 · W2142743911
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This case report details a combined transurethral and laparoscopic partial cystectomy with robotic repair for bladder endocervicosis in a patient with endometriosis, resulting in symptom resolution and subsequent conception.

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Abstract

BackgroundEndocervicosis, endosalpingiosis, endometriosis, and adenomyosis represent choristomas of Mullerian origin and are referred to as mullerianosis. These conditions frequently coexist, and they may present with pelvic pain, mass lesions, and/or infertility. Clinically, they are indistinguishable from one another, and histologically their epithelium is that of the endocervix, endosalpinx, or endometrium. Endocervicosis can be found in the urinary tract, frequently presenting as a bladder lesion or bladder dysfunction.CaseWe report here a case of bladder endocervicosis in a woman with extensive endometriosis and a bladder tumour who presented with chronic pelvic pain and infertility. Pelvic endometriosis was excised and vaporized with the CO2 laser, and the bladder lesion was excised in a combined transurethral and laparoscopic approach using the CO2 laser and robotic monopolar electrosurgical scissors. The cystotomy was then repaired using the robot, and the patient had an uneventful recovery with good clinical outcomes including spontaneous conception.ConclusionEndocervicosis of the urinary bladder is a rare Mullerian choristoma. Symptomatic lesions can be removed surgically by various surgical techniques, and a collaborative team-based approach is in the patient's best interest.

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Condition tags

endometriosischronic_pelvic_pain

MeSH descriptors

Cervix Uteri Choristoma Cystectomy Laparoscopy Robotics Urinary Bladder Diseases Adult Choristoma Choristoma Choristoma Cystectomy Electrosurgery Endometriosis Endometriosis Endometriosis Female Humans Infertility, Female Infertility, Female Infertility, Female

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License: CC0 · commercial use OK