Bladder Endometriosis In A Woman Who Complains About Chronic Pelvic Pain And Periodic Hematuria

Yıl 2017, Cilt: 31 Sayı: 2, 113 - 116, 23.08.2017

Serdar Balcı Çağlan Ertuğrul Kutsal Yörükoğlu , Burçin Tuna , Meral Koyuncuoğlu , Recep Emre Okyay Ömer Erbil Doğan Güven Aslan

Öz

A 36 year old woman with 2 pregnancies which one of
them is delivered by cesarean section 7 year ago and the other one was abortus
applied for periodic hematuria (menuria) and chronic pelvic pain. Cystoscopy
was performed and bladder mucosal biopsy was obtained because of suspicious
bladder mass in abdominopelvic ultrasonography. Pathological diagnosis was
bladder endometriosis. Gonadotrophin releasing hormon analog ( leuprolide
asetat) treatment was used for 6 months. 2 months after therapy she applied
again with pelvic pain. Diagnostic laparoscopy and second look cystoscopy was
performed and regression of the endometriotic foci were seen. Pain and palpable
mass out of pelvis may be a symptom of extrapelvic endometriosis although it is
frequently asymptomatic. Urinary endometriosis is an unrecoverable
disease, and collective approach of the gynecologist and urologist is necessary
for treatment options. The
severity of symptoms, spread of disease, probability of recurrences and cost of
treatment shoud be considered and accurate modality of the treatment shoud be
offered to the patient.

Anahtar Kelimeler

pelvic pain, hematuria, endometirosis

Kronik pelvik ağrı ve siklik hematüri ile başvuran bir kadında mesanede endometriozis

Öz

Otuz altı yaşında, gebelik 2 doğum 1 abortus 1 ve 7
yıl önce sezeryan öyküsü bulunan hasta siklik hematüri (menüri) ve kronik
pelvik ağrı yakınması ile başvurdu. Abdominopelvik ultrasonografide mesanede
kitle şüphesiyle sistoskopi yapılarak biopsi alındı. Patolojik tanı mesanede
endometriozis idi. Gonadotropin releasing hormon analoğu yakınması (leuprolide
asetat) tedavisi 6 ay uygulandı. Tedaviden 2 ay sonra kasık ağrısı şikayeti ile
tekrar başvurdu. Tanısal laparoskopi ve ikinci bakış sistoskopisi yapıldı ve
endometriozis odaklarının regrese olduğu saptandı. Sıklıkla asemptomatik olsa
da, ağrı ve pelvis dışında ele gelen bir kitlenin varlığı ekstrapelvik
endometriozisin semptomları olabilir. Üriner endometriozis gibi sağaltımı zor
bir hastalıkta tedavi basamaklarına kadın doğum ve üroloji uzmanları birlikte
karar vermelidir. Yakınmaların şiddeti, hastalığın yaygınlığı, tekrarlama
olasılığı ve tedavi maliyeti göz önüne alınarak doğru tedavi yöntemi hastaya
önerilmelidir.

Anahtar Kelimeler

pelvik ağrı, hematüri, endometriozis

Kaynakça

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