|Year : 2003 | Volume
| Issue : 2 | Page : 160-161
Vesical endometriosis: A case report
Dilip Kumar Pal
Urology Unit, Department of Surgery, Bankura Sammilani Medical College, Bankura, India
Dilip Kumar Pal
A-30, Govt. Housing Estate, Govindanagar, Side-B, Bankura - 722102
Source of Support: None, Conflict of Interest: None
Keywords: Urinary Bladder, endometriosis.
|How to cite this article:|
Pal DK. Vesical endometriosis: A case report. Indian J Urol 2003;19:160-1
| Case Report|| |
A 38-year-old woman, para 0+2 presented with haematuria for 3 days. She had a similar episode of haematuria 1 month back. On clinical examination she did not have any apparent abnormality.
Her urinalysis was normal except plenty of RBCs. Urine culture showed no growth. Serum haemoglobin and renal bio-chemical parameters were within normal limits. Ultrasonography suggested an endoluminal growth in the posterior wall of the bladder [Figure - 1]. Cyctoscopy suggested a lx1 cm sessile mass in the posterior bladder wall with surrounding congestion. Transurethral resection was done taking it as a bladder tumour. Histology suggested a midproliferative endometrial tissue [Figure - 2]. Then thorough search for endometriosis in other pelvic organs was made by per speculum examination, bimanual examination and diagnostic laparoscopy which revealed a normal size uterus, tubes, ovaries, pelvic peritoneum, cul-de-sac and uterosacral ligaments. In the postoperative period patient was given danazole 400 mg daily for 6 months. At 2years' of follow-up the patient was having normal mensuration with no recurrence.
| Comments|| |
Endometriosis is a common disease in child bearing age where endometrial tissue is deposited outside the uterine cavity.  Most commonly it affects organs like ovaries, uterine ligaments, Fallopian tube More Detailss, rectum and cervico-vaginal regions. Involvement of urinary tract is rare (1-2%) , and urinary bladder is the most frequently involved organ. , The classical presentations are cyclical urgency, frequency, suprapubic pain with or without haematuria and dyspareunia.  Endometriosis should be suspected with such presentation with no documented infection in child-bearing age. Ultrasonography, specially endovaginal sonography is more sensitive for diagnosis than CT or MRI. , Cystoscopy and biopsy gives the definite diagnosis. Urography, though nonspecific, is still useful to evaluate the integrity of upper urinary tracts  specially in disseminated cases. Though both surgical and medical management is advocated, surgical extirpation is more effective.  Excision of endometrioma followed by Gn-RH analogue is the preferred treatment, particularly in young patients where fertility should be preserved. Apart from traditional surgery, laparoscopic partial cystectomy is a better choice if the surgeon is experienced enough and it does not require ureteric transplantation. , Transurethral resection of vesical endometrial tissue may be a valid therapeutic option as in this case.
| References|| |
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[Figure - 1], [Figure - 2]