title: Laparoscopic management of 15 patients with infiltrating endometriosis of the bladder and a case of primary intravesical endometrioid adenosarcoma.
abstract: OBJECTIVE
  To report laparoscopic management of 15 patients with infiltrative bladder wall endometriosis and to report a case of endometrioid adenosarcoma.
  
  
  METHODS
  Prospective chart review.
  
  
  METHODS
  Referral center for endometriosis.
  
  
  METHODS
  Fifteen women with infiltrating endometriosis of the bladder.
  
  
  METHODS
  Laparoscopic segmental cystectomy and pathologic review of endometriotic bladder nodules in 15 patients.
  
  
  METHODS
  Location and characteristics of endometriotic bladder nodules.
  
  
  RESULTS
  Laparoscopic and cystoscopic evaluation confirmed that the endometriotic lesions were penetrating through the bladder wall. In 8 patients, the lesions were located in the dome of the bladder. In the remaining 7, the lesions were in the posterior wall, above the trigone. It was possible to treat all the lesions by performing a laparoscopic partial cystectomy. No intraoperative complications occurred. Deeply infiltrating endometriosis was confirmed on histologic evaluation in 14 cases. One patient was diagnosed with endometriosis on frozen section, but the final pathology revealed an adenosarcoma of the bladder.
  
  
  CONCLUSIONS
  Surgical excision of deeply infiltrating endometriosis of the bladder wall can be performed laparoscopically and offers the benefit of a definitive pathologic diagnosis to rule out an occult malignancy.
authors.affiliation: Center for Special Pelvic Surgery, Atlanta, Georgia, USA. info@nezhat.com
authors.forename: Ceana H
authors.initials: CH
authors.lastname: Nezhat
authors.forename: Shazia
authors.initials: S
authors.lastname: Malik
authors.forename: Joelle
authors.initials: J
authors.lastname: Osias
authors.forename: Farr
authors.initials: F
authors.lastname: Nezhat
authors.forename: Camran
authors.initials: C
authors.lastname: Nezhat
mesh_terms: D018195:Adenosarcoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D000328:Adult; D015653:Cystectomy; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D004715:Endometriosis / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D017699:Pelvic Pain; D012008:Recurrence; D024162:Second-Look Surgery; D001745:Urinary Bladder Diseases / Q000473:pathology / Q000601:surgery*