Combined transurethral and laparoscopic partial cystectomy for the treatment of bladder endometriosis

Fahad Algreisi, Hattan Badr, Daniya Alturkistani, George A. Vilos
In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2017 · vol. 6(3) , pp. 1122 · doi:10.18203/2320-1770.ijrcog20170597 · W2588646007
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⚙ AI-generated summary by claude@2026-06, 2026-06-13 ⓘ

This study describes a combined transurethral and laparoscopic partial cystectomy that successfully treated a patient with bladder endometriosis, confirming the approach's feasibility, safety, and effectiveness.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-13 · read from full text ⓘ

This case report studied a 22-year-old nulliparous woman evaluated for urinary tract symptoms including catamenial hematuria and suprapubic pain, with ultrasound and cystoscopy suggesting a bladder mass and MRI showing a 3×4 cm intramural lesion. The diagnosis of bladder endometriosis was confirmed by biopsy, and she underwent combined laparoscopic and transurethral resection using hydrodissection and CO2 laser energy laparoscopically plus monopolar electro-surgery cystoscopically, with laparoscopic repair of the bladder defect. The procedure was uneventful, she was discharged the same day, and at 8 weeks she remained symptom-free with histopathology confirming endometriosis. A major limitation is that the evidence is limited to a single patient case. This paper is centrally about endometriosis — it reports a combined surgical approach for intramural bladder endometriosis.

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Abstract

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.
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Combined transurethral and laparoscopic partial cystectomy for the treatment of bladder endometriosis DOI: https://doi.org/10.18203/2320-1770.ijrcog20170597Keywords: Bladder, Endometriosis, Laparoscopy, Partial cystectomy, TransurethralAbstract 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. Metrics References Sener A, Chew B, Duvdevani M, Brock G, Vilos G, Pautler S. Combined transurethral and laparoscopic partial cystectomy and robot-assisted bladder repair for the treatment of bladder endometrioma. J Minim Invasive Gynecol. 2006;13(3):245-8. Maccagnano C, Pellucchi F, Rocchini L, Ghezzi M, Scattoni V, Montorsi F et al. Diagnosis and treatment of bladder endometriosis: State of the Art. Urol Int. 2012;89(3):249-58. Bogart L, Berry S, Clemens J. Symptoms of interstitial cystitis, painful bladder syndrome and similar diseases in women: a systematic review. J Urol. 2007;177(2):450-6. Vilos G, Vilos A, Abu-Rafea B, Hollett-Caines J, Nikkhah-Abyaneh Z, Edris F. Three simple steps during closed laparoscopic entry may minimize major injuries. Surg Endosc. 2008;23(4):758-64. Missmer SCramer D. The epidemiology of endometriosis. Obstet Gynecol Clin North Am. 2003;30(1):1-19. Tirlapur S, Daniels J, Khan K. Chronic pelvic pain. Curr Opin Obstet Gynecol. 2015;27(6):445-8. Mettler L, Gaikwad V, Riebe B, Schollmeyer T. Bladder Endometriosis: Possibility of Treatment by Laparoscopy. JSLS. 2008;12:162-5. Balleyguier C, Chapron C, Dubuisson J, Kinkel K, Fauconnier A, Vieira M, et al. Comparison of Magnetic Resonance Imaging and Transvaginal Ultrasonography in Diagnosing Bladder Endometriosis. J Am Assoc Gynecol Laparosc. 2002;9(1):15-23. Walid MHeaton R. Laparoscopic partial cystectomy for bladder endometriosis. Arch Gynecol Obstet. 2008;280(1):131-5. Chapron C , Dubuisson JB , Jacob S , Fauconnier A , Da Costa Vieira M. Laparoscopy and bladder endometriosis. Gynecologie, Obstetrique and Fertilite. 2000;28(3):232-7.

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