The diagnosis and treatment of bladder and its peritoneal endometriosis

Objective In order to investigate the characteristics of pelvic endometriosis lesions in the bladder and its peritoneum,and the considerations of laparoscopic surgery for diagnosis and treatment.Methods The clinical data of 3297 patients with diagnosis of en-dometriosis by laparoscopic or open surgery in the Third Affiliated Hospital of Sun Yat-sen University and the Guangdong Provincial People's Hospital from January 2001 to 2010 December were analyzed retrospectively.Results The incidence of bladder peritoneal endometriosis was 29.5%,among of them,25.7% red lesions,63.2% blue lesions,and 11.1% white lesions.Red lesions were more present in stage Ⅱ (P0.05),while blue lesions were more present in stage Ⅱ (P0.05) and Ⅲ (P0.05),and white lesions were often present in stage Ⅳ (P0.01).Membrane adhesions were often caused at the blue lesion site (P0.05),while the white lesion site presented closed adhesion (P0.05).There were 5 patients with damage or suspicious damage of bladder and repair when separating the closed adhesion in the laparoscopic surgery using monopolar coagulation.7 cases of bladder endometriosis with partial cystectomy,including 5 cases by laparoscopy,patients had no recurrence.Conclusion Peritoneal bladder lesion is common phenomenon in the later phase of endometriosis,and close adhesion is main factor for the damage of bladder at laparoscopic surgery.