[Bladder endometriosis in a patient with cesarean history]

To describe a case of endometriosis of the urinary bladder in a patient with a previous history of cesarean section. Its possible relationship is discussed.

A 31-year-old female that had undergone cesarean section 8 years earlier is described. She had been referred by the gynecologist for further evaluation of a hyperechogenic area of about 2.5 cm in the posterior bladder wall. The patient had mild pollakiuria. Physical examination and analytical studies were normal except for microhematuria. CT suggested a possible uterine origin of the lesion. Endoscopic examination showed a lesion with a bullous appearance. Exploration and TUR with electrocoagulation of the bed were performed under anesthesia. Three small recurrences 0.5 cm in size were observed at 18 months' follow-up. TUR was repeated and the patient received complementary hormone therapy for 6 months.

Histopathological analyses of both TUR specimens demonstrated bladder endometriosis. At control evaluation 12 months after the second TUR, the patient is asymptomatic and the analytical and cystoscopic evaluation showed no significant findings.

There may be a possible relationship between some cases of endometriosis and previous cesarean section. Diagnosis is confirmed by histological analysis of tissue obtained by endoscopy. TUR and complementary hormone therapy is an alternative treatment option. The need for subsequent control follow-up is emphasized.