Müllerianosis, Endocervicosis, and Endosalpingiosis of the Urinary Tract: A Literature Review
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This literature review identified 37 cases of endocervicosis, 7 of endosalpingiosis, and 27 of müllerianosis in the urinary tract, with potential links to pelvic surgery and older patient age.
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This literature review searched Medline and Scopus for reported case(s) of urinary tract müllerianosis, endocervicosis, and endosalpingiosis in women up to October 2017, manually identifying and extracting details from 26 articles (37 bladder endocervicosis cases, 7 bladder endosalpingiosis case reports, and 27 bladder plus 3 lower ureter müllerianosis cases). The authors found that affected women were often older, frequently postmenopausal, and in many reports there was a possible association with prior pelvic surgery, especially hysterectomy and cesarean sections, and that local excision was sufficient in most cases; however, they emphasized that literature descriptions were limited and did not point to uniquely distinguishing features from each other. The paper concludes that etiology remains speculative and that these lesions should be considered in the differential diagnosis of pre- and postmenopausal women with pelvic pain, dyspareunia, lower abdominal pain/discomfort, dysuria, frequency, or hematuria. Relevance to endometriosis: the review is framed specifically to highlight these urinary tract müllerian lesions as distinct from endometriosis/adenomyosis and discusses diagnostic mimics including reference to bladder lesions that can be confused with adenocarcinoma and endometriosis-like processes.
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Abstract
INTRODUCTION AND HYPOTHESIS: We reviewed reported cases of endocervicosis, endosalpingiosis, and müllerianosis of the bladder or ureters in women in order to highlight these conditions as distinct from endometriosis or adenomyosis.
METHODS: Medline and Scopus searches of all cases published till the October 1, 2017. All retrieved references were searched manually to identify relevant articles.
RESULTS: Twenty-six articles reported endocervicosis. These included 37 cases described by the authors as endocervicosis of the bladder. We identified 7 case reports of bladder endosalpingiosis. There were 26 publications including 27 cases of müllerianosis of the bladder and 3 cases affecting the lower ureter. Literature descriptions are limited but available accounts do not point to features that uniquely distinguished these conditions. Affected women tended to be older, and in many cases, there was a possible relation to past surgery and particularly to hysterectomy and caesarean sections. Many cases were reported in postmenopausal women. Local excision was sufficient in most cases.
CONCLUSION: The etiology of these conditions remains speculative, but case reports raise a possible link to pelvic surgery. There is a need for more detailed accounts of these lesions, which should be considered in the differential diagnosis of pre- and postmenopausal women with pelvic pain, dyspareunia, lower abdominal pain or discomfort, dysuria, frequency, or hematuria.
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Abstract
Introduction and Hypothesis: We reviewed reported cases of endocervicosis, endosalpingiosis, and müllerianosis of the bladder or Ureters in women in order to highlight these conditions as distinct from endometriosis or adenomyosis. Methods: Medline and Scopus searches of all cases published till the October I, 2017. All retrieved references were searched manually to identify relevant articles. Results: Twenty-six articles reported endocervicosis. These included 37 cases described by theauthors as endocervicosis of the bladder. Weidentified 7 case reports of bladder endosalpingiosis. There were 26 publications including 27 cases of müllerianosis of the bladder and 3 cases affecting the lower Ureter. Literature descriptions are limited but available accounts do not point to features that uniquely distinguished these conditions. Affected women tended to be older, and in many cases, there was a possible relation to past surgery and particularly to hysterectomy and caesarean sections. Many cases were reported in postmenopausal women. Local excision was sufficient in most cases. Conclusion: The etiology of these conditions remains speculative, but case reports raise a possible link to pelvic surgery. There is a need for more detailed accounts of these lesions, which should be considered in the differential diagnosis of pre- and postmenopausal women with pelvic pain, dyspareunia, lower abdominal pain or discomfort, dysuria, frequency, or hematuria.
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Habiba, M., Brosens, I. & Benagiano, G. Müllerianosis, Endocervicosis, and Endosalpingiosis of the Urinary Tract: A Literature Review. Reprod. Sci. 25, 1607–1618 (2018). https://doi.org/10.1177/1933719118773441
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