VP05.13: Differentiating bladder endometriosis from other causes of pelvic pain and hematuria: a preliminary observation

To illustrate sonographic features to differentiate bladder endometriosis from other common bladder lesions causing pelvic pain and hematuria. The study included three cases of bladder endometriosis, one case of cystitis glandularis cystica and two cases of transitional cell carcinoma of the urinary bladder which were close to the uterovesical fold region. The patients presented with complaints of pelvic pain or hematuria or both. Transabdominal and transvaginal sonography with a filled bladder was performed which showed a bladder mass. The mass was observed in longitudinal and transverse plane. Both grey scale and colour Doppler images were obtained. The surface of the mass, its angle of contact with the bladder wall in transverse plane and colour score were compared in all cases. The cases of bladder endometriosis had a relatively smooth surface likely due to their submucosal nature (figure 1a, b). The mucosal lesions, namely bladder malignancy (figure 1c) and cystitis glandularis cystica (figure 1d) had a corrugated surface. Also, the angle of contact of endometriosis with the bladder wall was obtuse (figure 1e) while that of the other lesions was nearly perpendicular or acute (figure 1f). Bladder endometriosis cases had a colour score of 1 or 2 while the other lesions had a score of 2 or more. Grey scale and colour Doppler features of bladder endometriosis can help in differentiating it from other bladder lesions which mimic it clinically. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.