Successful surgical treatment for bladder endometriosis
Background. Endometriosis ranks third in the structure of gynecological morbidity in Russia. Genital endometriosis can be concurrent with urinary tract endometriosis in 1-2% of cases.Marinkin I.O., Feofilov I.V.
Case report. The paper describes a case of a 39-year-old patient with bladder endometriosis, as well as ovarian endometrioma and a variant of deep infiltrating endometriosis, such as uterosacral ligament endometriosis in her history; she was operated on by a gynecologist and an urologist.
Conclusion. The clinical case of bladder endometriosis is quite rare, which is characterized by the non-specific symptoms, rapid progression and mimicry of the tumor process. Bladder endometriosis should be included in the spectrum of differential diagnosis in women with genital endometriosis in their history, as well as in those with the cyclical nature of a pain symptom and gross hematuria relieved by antiestrogenic medications. The investigation has demonstrated the successful experience with surgical treatment for bladder endometriosis in cooperation with a gynecologist and an urologist.
Keywords
bladder endometriosis
bladder resection
clinical case
Supplementary Materials
- Fig. 1. MRI-signs of endometriosis of the wall of the urinary bladder of the patient E. 39 years: a, b - sagittal projections; c, d - frontal projections
- Fig. 2. Cystoscopic examination of the patient E. 39 years: endometrioid lesion of the posterior wall of the bladder
- Fig. 3. Transvaginal ultrasound of the urinary bladder of the patient E. 39 years of age: wall formation (3.0 × 3.9 × 2.6 cm) on a broad base, with uneven fuzzy contours, irregular shape
- Fig. 4. Pathomorphological examination of the resected wall of the bladder of the patient E. 39 years: polymorphic heterotopies in the mucosa (a) and the muscular membrane (b). Staining with hematoxylin and eosin. En. 250.
References
1. Berling T., Bolze P.A., Berthiller J., Dubernard G., Lamblin G., Paparel P., Golfier F. Morbidity and functional long-term follow-up of patients with surgical treatment of urinary tract endometriosis. Gynecol. Obstet. Fertil. Senol. 2017; 45(6): 327-34. doi: 10.1016/j.gofs.2017.05.006.
2. Darwish B., Stochino-Loi E., Pasquier G., Dugardin F., Defortescu G., Abo C., Roman H. Surgical outcomes of urinary tract deep infiltrating endometriosis. J Minim. Invasive Gynecol. 2017; 24(6): 998-1006. doi: 10.1016/j.jmig.2017.06.005.
3. Knabben L., Imboden S., Fellmann B., Nirgianakis K., Kuhn A., Mueller M.D. Urinary tract endometriosis in patients with deep infiltrating endometriosis: prevalence, symptoms, management, and proposal for a new clinical classification. Fertil. Steril. 2015; 103(1): 147-52. doi: 10.1016/j.fertnstert.2014.09.028.
4. Чупрынин В.Д., Хилькевич Е.Г., Буралкина Н.А., Мельников М.В., Чурсин В.В., Вередченко А.В., Саидданеш Ш.Ф. Взгляд общего хирурга на оперативное лечение глубокого инфильтративного эндометриоза. Акушерство и гинекология. 2017; 4: 45-52. http://dx.doi.org/10.18565/aig.2017.4.45-52. [Chuprynin V.D., Khilkevich E.G., Buralkina N.A., Melnikov M.V., Chursin V.V., Veredchenko A.V., Saiddanesh Sh.F. A general surgeon’s opinion about surgical treatment for deeply infiltrating endometriosis. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (4): 45-52. (in Russian) http://dx.doi.org/10.18565/aig.2017.4.45-52]
5. Chapron C., Chiodo I., Leconte M., Amsellem-Ouazana D., Chopin N., Borghese B., Dousset B. Severe ureteral endometriosis: the intrinsic type is not so rare after complete surgical exeresis of deep endometriotic lesions. Fertil. Steril. 2010; 93(7): 2115-20. doi: 10.1016/j.fertnstert.2009.01.102.
6. Cavaco-Gomes J., Martinho M., Gilabert-Aguilar J., Gilabert-Estélles J. Laparoscopic management of ureteral endometriosis: A systematic review. Eur. J. Obstet. Gynecol. Reprod. Biol. 2017; 210: 94-101. doi: 10.1016/j.ejogrb.2016.12.011.
7. van Beek J.J. Bladder endometriosis, a remarkable resemblance in a monozygotic twin. Gynecol. Surg. 2010; 7(4): 375-8. doi: 10.1007/s10397-009-0487-1.
8. Leone Roberti Maggiore U., Ferrero S., Candiani M., Somigliana E., Viganò P., Vercellini P. Bladder endometriosis: A systematic review of pathogenesis, diagnosis, treatment, impact on fertility, and risk of malignant transformation. Eur. Urol. 2017; 71(5): 790-807. doi: 10.1016/j.eururo.2016.12.015.
Received 28.07.2017
Accepted 22.09.2017
About the Authors
Marinkin Igor Olegovich, MD, professor, head of the Department of Obstetrics and Gynecology, Rector of Novosibirsk State Medical University, Ministry of Health of Russia. 630091, Russia, Novosibirsk, Krasny Prospekt, 52. Tel.: +73832223204. E-mail: rector@ngmu.ruFeofilov Igor Viktorovich, MD, professor, head of the Department of Urology, Novosibirsk State Medical University, Ministry of Health of Russia.
630091, Russia, Novosibirsk, Krasny Prospekt, 52. Tel.: +79059380298. E-mail: fil_urolog@mail.ru
For citations: Marinkin I.O., Feofilov I.V. Successful surgical treatment for bladder endometriosis. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (4): 150-4. (in Russian)
https://dx.doi.org/10.18565/aig.2018.4.150-154
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