OP15.06: Bladder detrusor endometriosis: where does it come from?

To evaluate the appearance of bladder endometriosis on ultrasound and to elucidate the pathogenesis and possible association with uterine adenomyosis. 11 women with ultrasound diagnosis and histological confirmation of bladder detrusor endometriosis. Preoperative workup included history, clinical examination, cystoscopy and 2D/3D transabdominal/transvaginal ultrasound. Partial cystectomy was performed and bladder endometriosis was confirmed at histopathology by endometrial glands and stroma infiltrating the bladder muscularis propria. Mean age 35.7 (29–47), 3 parous all vaginal deliveries. Symptoms: dysmenorrhea (100%), dyspareunia (72.7%), urinary (81.8%), gastrointestinal (45.5%) and infertility (54.5%). Additional involvement: ovarian (4), uterosacral (4), posterior compartment (4), ureteral (2). On ultrasound all women had sonographic signs of adenomyosis. Mean maximal nodule diameter in the bladder was 32.7 (20–52) mm. Ten women had nodules penetrating the bladder detrusor, nine originated from an adenomyoma in the anterior uterine wall with an hourglass appearance. Mean ASRM score was 47.2 (6–148), four had stage 4 endometriosis. Two had isolated bladder endometriosis. All underwent partial bladder cystectomy with complete resection of the nodule and pathology confirmed bladder detrusor endometriosis without mucosal penetration. Mean follow-up interval was 12.5 (2–30) months and all are free of bladder symptoms, three have conceived. Supporting information can be found in the online version of this abstract 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.