Anatomopathological lesions of bladder endometriosis are heterogeneous

To present the anatomopathological characteristics of deep bladder endometriosis.

Descriptive anatomapathological study.

A university hospital department of gynecological surgery.

Eleven consecutive patients complaining of pelvic pain and painful urinary functional symptoms.

Laparoscopic partial cystectomy.

Macroscopic and microscopic characteristics of deep bladder endometriosis lesions.

Deep bladder endometriosis lesions were extremely heterogeneous, not only in any one patient but also from one patient to another. Bladder muscularis propria presented three aspects: [1] hyperplasia of the fibromuscular tissue (4/11); [2] simple dissociation of the smooth muscle fiber bundles with no veritable "disorganization" (4/11); [3] simple thickening of the interstitial collagen network, or sclerosis (3/11). A histological adenomyotic nodule aspect was only observed in one patient (9%).

Bladder endometriosis is an enigmatic disease. No hypothesis can be proposed as a single explanation for its pathogenesis.