Bladder Endometriosis and Endocervicosis: Presentation of 2 Cases with Endoscopic Management and Review of Literature

Abstract

Urinary tract endometriosis and endocervicosis are an uncommon pathologic finding, with a common embryological origin. We present 2 cases of female patients with bladder mass. The first one was a finding of a nodular formation in the bladder during study of a nonviable foetus and the second was an incidental finding of a neoformation in the fundus of the bladder during the realization of an ultrasound. In both cases, we performed a surgical management with transurethral resection. Histopathological examination revealed a bladder endometrioma in the first case and endocervicosis with associated endometriosis in the second.

Bladder Endometriosis: A Systematic Review of Pathogenesis, Diagnosis, Treatment, Impact on Fertility, and Risk of Malignant Transformation

“…TUR surgery. TUR has been proposed for the treatment of BE even though evidence supporting the efficacy and safety of this procedure is poor (Table 5) [108][109][110]. In fact, this surgical technique does not properly apply to treatment of this type of lesion from a pathogenic point of view [77].…”

“…In fact, this surgical technique does not properly apply to treatment of this type of lesion from a pathogenic point of view [77]. Since the nodule develops from the outer layer of the bladder wall towards the inner layer, complete excision of the endometriotic lesion is virtually unachievable, exposing the patient to a high risk of bladder perforation and shortterm recurrence of both symptoms and disease [107][108][109][110]. Therefore, on the basis of the evidence available, TUR should not be performed for the treatment of BE.…”

Laparoscopic Approach in Bladder Endometriosis, Intraoperative and Postoperative Outcomes

“…Furthermore, the data of this study show that an endometriosis nodule is not always detectable with cystoscopy (Table II). TUR has a high risk of bladder perforation and a recurrence of endometriosis (25,(27)(28)(29). For this reason, TUR cannot be considered as an efficient treatment of bladder endometriosis (12).…”