Diagnosis and Management of Bladder Endometriosis

作者：Simone Ferrero, Stefano Bogliolo, Mario Valenzano Menada, Nicola Ragni, Ennio Biscaldi, Giovanni Bruno Camerini, Valentino Remorgida · 发表于：Journal of Endometriosis and Pelvic Pain Disorders · 年份：2009 · DOI：10.1177/2284026509001003-401 · 被引用次数：5 · 研究领域：Endometriosis Research and Treatment、Uterine Myomas and Treatments、Endometrial and Cervical Cancer Treatments

Bladder endometriosis is defined as full-thickness infiltration of the detrusor; small sub-peritoneal implants and small nodules of the vesicouterine fold cannot be considered to be bladder endometriosis. In women with endometriosis, urinary tract involvement is rare (1% to 5% of cases) but the bladder is affected in 80% to 84% of these cases. Symptoms of bladder endometriosis are various and not specific: besides pain symptoms, patients may complain of urinary frequency, urgency, urge incontinence, dysuria, and hematuria. Although bladder endometriosis may be suspected at vaginal examination, the preoperative diagnosis is based on transvaginal ultrasonography and magnetic resonance imaging. Medical therapies may temporarily reduce the severity of symptoms related to the presence of vesical endometriosis; however, the symptoms may persist in cases of large bladder nodules or may recur after cessation of therapy. Surgery represents the gold standard for treatment of bladder endometriosis and laparoscopy should be preferred to laparotomy. Excision of bladder nodules may be performed either by partial-thickness resection or by partial cystectomy according to the size and depth of the infiltration of the lesions in the bladder wall. Persistent improvement of symptoms has been demonstrated at long-term follow-up, particularly when the lesions involve the vesical dome.