Endometiosis vesicae urinarie after cesarean section

A Palatyński, J Gruszczynska-Walczak
In: Geburtshilfe und Frauenheilkunde · 2007 · vol. 67(09) · doi:10.1055/s-2007-989176 · W2730249202
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This study investigated 16 women with bladder endometriosis post-cesarean section, reporting pelvic pain, menstrual-related urinary symptoms, and surgical interventions including bladder resection and intestinal augmentation.

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This study examined 16 women aged 41 to 48 who developed urinary bladder endometriosis following cesarean sections performed several years prior. The patients presented with cyclic pelvic pain and hematuria during menstruation, leading to diagnoses confirmed by imaging and histopathological analysis of bladder segments. Surgical management involved hysterectomy with adnexectomy and partial bladder resection, with complex cases requiring intestinal reconstruction to enlarge bladder capacity due to extensive infiltration. This paper is centrally about endometriosis — specifically the rare presentation of deep infiltrating endometriosis involving the urinary bladder after cesarean section.

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Abstract

Clinical problem is endometriosis, which grows into the posterior wall of the urinary bladder after caesarean section. Our study material consists of 16 patients, aged 41–48 years. One caesarean section was carried out in 13 patients, 5–7 years ago, and two caesarean sections in three women in 1,0–2,0 year interval, 4–6 years ago. The main symptom was pelvic pain of 1,5–2 year duration, which increased during menses. The pain intensity was moderate in 11 women and very severe in five patients during the miction. In 13 patients erythrocyturia, and in three ones haematutia occurred during the menses. Ultrasonography, urography and computer tomography were carried out in all patients. The segments taken from bladder confirmed endometriosis in ten patients, and in four ones the macrophages loaded with haemosiderin were stated, and in two women histopathological diagnosis was impossible due to scanty materials. In all patiens hysterectomy with adnexectomy were carried out. Regarding urologic operations, in 13 patients a partial resection of the urinary bladder was performed. In three cases, a great endometrial infiltration caused the necessity of the urinary bladder's wall resection to the border of trigone of the bladder and neck of the urinary bladder. In this situation to enlarge the capacity of the bladder, a small intestine was used, connecting it with the neck of the bladder.
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Subscribe to RSS DOI: 10.1055/s-2007-989176 Endometiosis vesicae urinarie after cesarean section Clinical problem is endometriosis, which grows into the posterior wall of the urinary bladder after caesarean section. Our study material consists of 16 patients, aged 41–48 years. One caesarean section was carried out in 13 patients, 5–7 years ago, and two caesarean sections in three women in 1,0–2,0 year interval, 4–6 years ago. The main symptom was pelvic pain of 1,5–2 year duration, which increased during menses. The pain intensity was moderate in 11 women and very severe in five patients during the miction. In 13 patients erythrocyturia, and in three ones haematutia occurred during the menses. Ultrasonography, urography and computer tomography were carried out in all patients. The segments taken from bladder confirmed endometriosis in ten patients, and in four ones the macrophages loaded with haemosiderin were stated, and in two women histopathological diagnosis was impossible due to scanty materials. In all patiens hysterectomy with adnexectomy were carried out. Regarding urologic operations, in 13 patients a partial resection of the urinary bladder was performed. In three cases, a great endometrial infiltration caused the necessity of the urinary bladder's wall resection to the border of trigone of the bladder and neck of the urinary bladder. In this situation to enlarge the capacity of the bladder, a small intestine was used, connecting it with the neck of the bladder.

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