Bladder Endometriosis: Symptoms and Pregnancy Outcomes
Hailan Yan1, Xiaoyan Li1, Yi Dai1
1Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College (Yan, Li, Dai, Shi, Wu, Gu, Zhang, Li, Zhang, Lv, and Leng), Beijing, China; National Clinical Research Center for Obstetric & Gynecologic Diseases (Yan, Li, Dai, Shi, Wu, Gu, Zhang, Li, Zhang, Lv, and Leng), Beijing, China.
Journal of Minimally Invasive Gynecology
|September 13, 2024
Summary
Bladder endometriosis significantly impacts urinary function, with factors like prior cesarean sections and deeper lesion invasion increasing symptom risk. Most patients experience symptom relief post-treatment, though fertility effects require further study.
Area of Science:
- Gynecology
- Urology
- Reproductive Medicine
Background:
- Bladder endometriosis is a rare condition causing significant urinary symptoms.
- Understanding associated factors is crucial for diagnosis and management.
Purpose of the Study:
- To investigate clinical features of bladder endometriosis.
- To identify factors linked to urinary symptoms, pregnancy outcomes, and long-term symptom recurrence.
Main Methods:
- Retrospective cohort study at a tertiary referral hospital.
- Inclusion of 47 surgically confirmed bladder endometriosis patients (2012-2023).
- Analysis of clinical, pathological, and reproductive outcomes.
Main Results:
- 57.4% of patients reported urinary symptoms (frequency, urgency, dysuria, hematuria).
- Urinary symptoms correlated with previous cesarean sections, dysmenorrhea, anterior compartment obliteration, proximity to ureteral orifice, and mucosal invasion.
- 66.7% of patients desiring pregnancy achieved it; miscarriage rate was 25.0% (ages 27-40).
- All patients had symptom relief at one year, with low recurrence (2 patients).
Conclusions:
- Previous cesarean section, dysmenorrhea, anterior compartment obliteration, trigonal lesions, and mucosal invasion are associated with urinary symptoms.
- While pregnancy is achievable post-surgery, bladder endometriosis's independent effect on fertility needs more research.
- Symptom relief is common, with minimal recurrence observed.
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