Diagnostic and Therapeutic Approach to Patient with Urinary Tract Endometriosis:A Case Report

Objectives To discuss the diagnostic and treatment strategy of endometriosis(EMS) of the urinary tract. Methods We report a female patient with bladder endometriosis, an unusual clinical presentation of the disease. A retrospective investigation of clinical data, therapeutic aspects and outcome was made. The characteristics of the lesion were defi ned after a complete evaluation of endometriosis disease by clinical exam and imaging techniques. The diagnosis of endometriosis was performed by cystoscopy and biopsies of lesions. Results Pollakiuria, urgency, odynuria, haematuria, and pelvic pain that only occurred during the menstrual period present as predominant symptoms of urinary tract endometriosis. The patient successfully underwent partial cystectomy and total hysterectomy and unilateral adnexectomy. Pathological diagnosis from the resected specimen was identical to preoperative diagnosis, i.e., bladder endometriosis. Conclusions Urinary endometriosis should be considered when a women presents with low urinary tract symptoms. Its management is first diagnostic and then remedial. Surgery is the primary treatment of choice. We believe partial cystectomy should be considered as an initial option, and total hysterectomy and unilateral adnexectomy may be considered in selected cases.