[Isolated vesical endometriosis - a case report]

Although endometriosis affects up to 15% of the female population with childbearing potential, isolated endometriosis of the urinary tract is not a frequent occurrence, as it involves only 1 to 2% of all endometriosis patients. The chronic pelvic pain syndrome ultimately related to endometriosis is often both a diagnostic and therapeutic challenge Materials and methods: This paper presents the case of a female patient reporting with severe urinary symptoms. Following cystoscopy and ultrasonography investigations, a suspected endometrioid lesion of the urinary bladder has been evidenced. The patient-reported pain was rated using a 10-point visual analogue scale (VAS). The patient has not received pharmacotherapy.

A partial laparoscopic full-thickness excision of the urinary bladder wall with the evidenced lesion has been performed. The urinary bladder wall has been sutured using two layers of sutures applied by laparoscopy. Postoperative histopathology examination revealed a deep infiltrating endometriosis lesion of the urinary bladder wall. Following surgery, the patient's complaints have withdrawn completely, and no subsequent pharmacotherapy was instated.

Isolated endometriosis of the urinary tract, including the urinary bladder, is not a common pathology. Nevertheless, it should always be taken into account in patients with dysuria or symptoms suggestive of bladder malignancy. Total laparoscopic excision of the lesion remains the treatment of choice, and in most cases provides patients with complete withdrawal of symptoms, and only minimal incidence of recurrences, as well as limited risk of early and delayed complications.