Diagnosis of infiltrating bladder endometriosis after fourth cesarean section

Abstract

Objectives: This case report highlights the clinical presentation, diagnostic challenges, and effective management of bladder endometriosis, while emphasizing the importance of considering this diagnosis in patients with chronic pelvic pain and urinary symptoms.

Methods: A 32-year-old woman presented with severe pelvic pain, dysuria, and dyspareunia. Diagnosis of bladder endometriosis was achieved through clinical suspicion supported by vaginal ultrasound, 3D imaging, and magnetic resonance imaging.

Results: Conservative medical treatment provided temporary relief, which necessitated resection of endometriotic nodule.

Conclusions: Due to its rarity and non-specific presentation, bladder endometriosis is often underdiagnosed or misdiagnosed. In this case, the patient's pain can be correlated with the deeply infiltrating nature of the endometriotic lesions, causing irritation, and involvement of the bladder.

Keywords: bladder endometriosis; deep infiltrating endometriosis; endometriosisa; laparoscopic cystectomy.

Fig. 1

MRI findings showing bladder endometriosis: (a) longitudinal section and (b) transverse section.

Fig. 2

(a) Intra‐op visualization of the bladder mass. (b) Intra‐op bladder mass excision. (c) Excised bladder mass.

Fig. 3

Pelvic ultrasound showing bladder endometriotic nodule (August 2023).