Mesane Endometriozis Olguları ve Literatüre Genel Bakış

Abstract

Endometriozis, endometriyal bezlerin uterus boşluğunun dışında yer aldığı kronik ve bening bir hastalıktır. İzole mesane tutulumu, derin infiltre pelvik endometriozisin bir parçası olarak mesane endometriozisi bileşeni olan nadir bir durumdur. Görüntüleme ve pelvik muayene ile açıklanamayan dizüri, üriner semptomları olan olgularında mesane endometriozisi akılda tutulmalıdır. Manyetik rezonans görüntüleme tanıyı desteklemek için kullanılabilir. Bu olgu sunumunda mesane endometriozisi olan iki hasta değerlendirildi. Ameliyat sonrası patolojik inceleme ile kesin tanı konan hastalara gestagen preparatları ile konservatif tedavi uygulandı. 3-6 ay sonraki takibinde ultrasonografik görüntülerde ve semptomlarda nüks izlenmedi. Nadir görülen ve geç tanı alan bir klinik olması nedeniyle klinisyenlerin dirençli üriner sistem semptomları, varlığında mesane endometriozisini akılda tutmaları gerekmektedir.

Keywords

• Endometriozis
• İnfertilite
• Mesane endometriozisi
• Sistoskopi
• Uterus

A Rare Case of the Bladder Endometriosis and Overview of the Literature

Abstract

Endometriosis is a chronic, non-cancerous condition characterized by the growth of endometrial tissue outside the uterus. Isolated involvement of the bladder is rare and often part of a broader deep infiltrating pelvic endometriosis. Bladder endometriosis should be considered in cases of unexplained dysuria and urinary symptoms not clarified by imaging or pelvic examination. Magnetic resonance imaging can be used as a diagnostic aid. This case report presents two patients diagnosed with bladder endometriosis postoperatively. Conservative treatment with gestagen preparations was administered. After 3-6 months of follow-up, ultrasonography and symptom assessment showed no recurrence. Clinicians should be aware of bladder endometriosis as a potential cause of persistent urinary symptoms, given its rarity and often delayed diagnosis.

Keywords

• Endometriosis
• Infertility
• Bladder endometriosis
• Cystoscopy
• Uterus

References

1. Kudva R, Hegde P. Mullerianosis of the urinary bladder. Indian J Urol. 2012;28(2):206–7. https://pubmed.ncbi.nlm.nih.gov/22919142/
2. Koren J, Mensikova J, Mukensnabl P, Zamecnik M. Mullerianosis of the urinary bladder: report of a case with suggested metaplastic origin. Virchows Arch. 2006;449(2):268–71. https://pubmed.ncbi.nlm.nih.gov/16832656/
3. Westney OL, Amundsen CL, Mcguire EJ. Bladder endometriosis:Conservative management. J Urol. 2000;163(6):1814–7. https://www.auajournals.org/doi/10.1016/S0022-5347%2805%2967550-7
4. Fedele L, Bianchi S, Montefusco S, Frontino G, Carmignani L. A gonadotropin-releasing hormone agonist versus a continuous oral contraceptive pill in the treatment of bladder endometriosis. Fertil Steril. 2008;90(1):183–4. https://pubmed.ncbi.nlm.nih.gov/18177868/
5. Piriyev E, Schiermeier S, Römer T. Laparoscopic Approach in Bladder Endometriosis, Intraoperative and Postoperative Outcomes. In Vivo (Brooklyn). 2023;37(1):357–65.
6. Foster RH, Wilde MI, Kuhl H, Spona J. Dienogest. Drugs. 1998;56(5):825–33. https://pubmed.ncbi.nlm.nih.gov/9829156/
7. Park SY, Kim SH, Chae HD, Kim CH, Kang BM. Efficacy and safety of dienogest in patients with endometriosis: A single-center observational study over 12 months. Clin Exp Reprod Med. 2016;43(4):215–20. www.eCERM.org
8. Banner H, Murji A. Bladder endometriosis in pregnancy. Am J Obstet Gynecol. 2020;223(3):450. https://pubmed.ncbi.nlm.nih.gov/32142831/

9. Maddern J, Grundy L, Castro J, Brierley SM. Pain in Endometriosis. Front Cell Neurosci. 2020;14. https://pubmed.ncbi.nlm.nih.gov/33132854/
10. Sherman AK, MacLachlan LS. A Review of Urinary Tract Endometriosis. Curr Urol Rep. 2022;23(10):219–23. https://link.springer.com/article/10.1007/s11934-022-01107-8
11. Vercellini P, Somigliana E, Consonni D, Frattaruolo MP, De Giorgi O, Fedele L. Surgical versus medical treatment for endometriosis-associated severe deep dyspareunia: I. Effect on pain during intercourse and patient satisfaction. Hum Reprod. 2012;27(12):3450–9. https://pubmed.ncbi.nlm.nih.gov/22926841/
12. Vercellini P, Crosignani P, Somigliana E, Vigan P, Frattaruolo MP, Fedele L. “Waiting for Godot”: a commonsense approach to the medical treatment of endometriosis. Hum Reprod. 2011;26(1):3–13. https://pubmed.ncbi.nlm.nih.gov/21071490/
13. Pastor-Navarro H, Giménez-Bachs JM, Donate-Moreno MJ, Pastor-Guzman JM, Ruíz-Mondéjar R, Atienzar-Tobarra M, et al. Update on the diagnosis and treatment of bladder endometriosis. Int Urogynecol J. 2007;18(8):949–54. https://link.springer.com/article/10.1007/s00192-007-0342-8
14. Köhler G, Faustmann TA, Gerlinger C, Seitz C, Mueck AO. A dose-ranging study to determine the efficacy and safety of 1, 2, and 4 mg of dienogest daily for endometriosis. International Journal of Gynecology & Obstetrics. 2010;108(1):21–5. https://onlinelibrary.wiley.com/doi/full/10.1016/j.ijgo.2009.08.020
15. Hirata T, Koga K, Taniguchi F, Takazawa N, Honda R, Tanaka T, et al. National survey of bladder endometriosis cases in Japan. Journal of Obstetrics and Gynaecology Research. 2021;47(4):1451–61. https://onlinelibrary.wiley.com/doi/full/10.1111/jog.14656