Laparoscopic Findings Associated with Bladder Endometriosis Are Correlated with Disease Severity

Jerome Bouaziz, Jérôme Bouaziz, Zohar Dotan, Michal Zajicek, M. Zajicek, Matityahu Zolti, Howard Carp, Mordechai Goldenberg, Daniel S Seidman, David Soriano
Journal of laparoendoscopic & advanced surgical techniques. Part A · 2017 · vol. 27(12) , pp. 1245–1250 · doi:10.1089/lap.2016.0612 · PMID:28661726 · W2726742317
article OA: closed CC0 ⤵ 1 in-corpus citation
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This study identified three laparoscopic findings—kissing round ligaments, anatomical distortion, and proximal tubal occlusion—that can help diagnose bladder endometriosis and correlate with its severity.

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Abstract

STUDY OBJECTIVE: Bladder involvement is rare in endometriosis. The prevalence is estimated to be ∼1% in patients with endometriosis. However, this figure seems to be an underestimation. The diagnosis of bladder endometriosis might be missed during laparoscopy. The aim of this study was to determine an intraoperative visual score of pelvic lesions that help the surgeon suspect bladder endometriosis. Design, Design Classification: A retrospective analysis was performed on the intraoperative photographs and videos of 69 patients with histological confirmation of bladder endometriosis. SETTING: A tertiary referral center. PATIENTS: Sixty-nine patients with bladder endometriosis were operated on in our center over a 9-year period. INTERVENTIONS: Evaluation and analysis of intraoperative laparoscopic findings. MAIN RESULTS: We found three subtypes of laparoscopic findings that can assist with diagnosing bladder endometriosis. The most prominent sign was named "kissing round ligaments" (Type K), in which the right and left round ligaments appear closer to each other than usual or even touching one another. This sign is strongly associated with full-thickness invasion of the bladder. Other laparoscopic findings that indicated bladder endometriosis were anatomical distortion (Type A) and proximal occlusion of the tubes (Type B). We further define a scoring system for the lesion that correlates with the severity of the bladder endometriosis from superficial lesions to full thickness. CONCLUSION: Bladder endometriosis is a rare condition and often remains undiagnosed. Indeed, even during surgery, bladder endometriosis can be missed if the operator is not aware of the suggestive signs. Operative laparoscopic findings may help the surgeon to diagnose bladder endometriosis, and these signs correlate with the severity of the disease.

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Condition tags

mesh:D004715endometriosisbladder_endometriosis

MeSH descriptors

Endometriosis Laparoscopy Urinary Bladder Urinary Bladder Diseases Adult Endometriosis Endometriosis Female Humans Laparoscopy Middle Aged Retrospective Studies Tertiary Care Centers Urinary Bladder Urinary Bladder Urinary Bladder Diseases Urinary Bladder Diseases

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (16)

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