Introduction and Objectives
Endometriosis affects 1–2% of menstruating women and up to 20% women after surgical pelvic operations. Most cases occur between 25–45 yrs. The peak incidence is around 30–40 yrs. Involvement of the urinary tract is seen in about 1% cases of this disease.
Material and Methods
Since 1983 till 2008 seven female patients (age 32–46 yrs, mean age 37.6yrs) initially referred as bladder tumor underwent trans urethral resection. Histopathological examination revealed endometriosis of the urinary bladder. Clinical data are presented in the table I. The patients were followed-up with US and cystoscopy.
|Case, Initials, Age (y)||Symptoms||US-Scan||Treatment||Results/follow-up|
|1, ZG, 32||Hematuria||Not performed||TURBT, hormonal||Asymptomatic during 276 months|
|2, ON, 32||Hematuria||Bladder tumor||TURBT. Partial resection of the bladder, hormonal||Asymptomatic 204 months|
|3, KB, 32||recurrent flank pain||Paravesical tumor compressing lower ureter||TURBT Nephrectomy hormonal||Asymptomatic 204 months|
|4, KM, 40||asymptomatic||Bladder tumor||TURBT, hormonal||Asymptomatic 120 months|
|5, SA, 40||asymptomatic||Bladder tumor||Cystectomy hormonal||Asymptomatic 84 months|
|6, GA, 46||dysuria||Bladder tumor||TURBT||Died 4 months later (Stroke)|
|7, WM, 46||dysuria||Bladder tumor||TURBT Hormonal.||Asymptomatic 6 Months later|
Histopathological examination revealed endometriosis of the urinary bladder. 6 out of 7 patient underwent adjuvant personally tailored hormonal treatment. Good results we achieved in all cases, after combined (surgical and hormonal) treatment in 6 cases and in 1 case after surgical treatment only. One patient died 4 months post TURT of stroke. Mean follow up was 128 months.
TURBT with adjuvant hormonal treatment of bladder endometriosis permits to achieve good long term results in all cases. No neoplastic transformation was observed during the follow-up.
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.