[Bladder endometriosis - long-term efficacy of radical laparoscopic surgery]

While endometriosis affects up to 15% of the female population of childbearing potential, the involvement of the urinary system is a relatively rare occurrence. It affects only 1-2% of all patients with endometriosis. Symptoms consistent with chronic pelvic pain syndrome or dysuria, related to endometriosis, remain a challenge in both diagnostic and therapeutic terms.

The aim of the study was to evaluate the long term effects of advanced laparoscopic surgery of deep infiltrating endometriosis of the bladder.

This paper is a summary of radical laparoscopic surgery results in 21 patients with urinary bladder endometriosis. The majority of cases involved primary endometriosis of the bladder, there was only one case of postoperative bladder endometriosis, that was diagnosed many years after a caesarean section. All patients underwent radical laparoscopic surgery.

All endometriotic lesions involving the bladder wall were excised within healthy tissue margins in all patients undergoing surgery. Pathology confirmed endometriosis in all cases. Dysuria and chronic pelvic pain have completely withdrawn in all patients, and postoperative observation at the time of writing (median period of 30.7 months, range 4.1-111.2 months) revealed a consistent and durable therapeutic effect of surgery.

Endometriosis of the urinary bladder is not a common pathology. Nevertheless, it should be taken into consideration in cases of unexplained dysuria or imaging suggestive of urinary bladder malignancy. The treatment of choice is radical laparoscopic excision of the endometriotic lesions. This modality usually ensures complete resolution of symptoms, along with a marginal risk for recurrence and minimal early and late complication rates.