Bladder Endometriosis
Bladder (Urinary Bladder) Endometriosis – A Comprehensive Guide
What is Bladder Endometriosis?
Bladder endometriosis is a rare form of deep infiltrative endometriosis caused by the implantation of endometrial tissue into the bladder wall. It is usually associated with advanced-stage disease.
How Does It Occur?
It develops through the spread of endometrial cells in the pelvic cavity and their invasion into the bladder wall. It is often associated with uterosacral ligament and anterior compartment involvement.
Symptoms
The most common symptoms are increased burning during urination, frequent urination, bladder pain, and sometimes blood in the urine (catamenial hematuria) during menstruation.
Menstruation-Related Symptoms
The cyclic nature of symptoms is crucial for diagnosis. Urinary complaints that become prominent especially during menstruation are typical.
How is it Diagnosed?
Diagnosis is made through detailed anamnesis, gynecological examination, and imaging methods (especially MRI and transvaginal ultrasound). Cystoscopy can also be helpful.
Ultrasound Findings
Hypoechoic nodular lesions and thickening can be observed in the bladder wall. High accuracy can be achieved with experienced ultrasound.
MRI Findings
On MRI, T2 hypointense, fibrotic nodules and areas of invasion can be seen in the bladder wall. It is highly valuable for surgical planning.
Treatment Approach
Treatment is divided into medical and surgical. Hormonal therapies provide symptom control, but surgery is often necessary for deep lesions.
Surgical Treatment
Laparoscopic partial cystectomy or lesion excision can be performed. A multidisciplinary approach is important due to bladder surgery.
Complications and Follow-up
Bladder functions should be monitored after surgery. Long-term follow-up is necessary due to the risk of recurrence.
Conclusion
Bladder endometriosis is a rare but important clinical condition. It can be successfully managed with accurate diagnosis and an appropriate surgical approach.