Laparoscopic management of 15 patients with infiltrating endometriosis of the bladder and a case of primary intravesical endometrioid adenosarcoma.
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.
Nezhat
Ceana H
CH
Center for Special Pelvic Surgery, Atlanta, Georgia, USA. info@nezhat.com
Malik
Shazia
S
Osias
Joelle
J
Nezhat
Farr
F
Nezhat
Camran
C
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*