A surgical case involving bladder endometriosis

Abstract

The purpose is to demonstrate a surgical case of severe endometriosis involving a bladder endometriotic nodule. This patient has a large 4-cm endometriotic nodule which obliterates the uterovesical pouch and invades the bladder. A video recording was made of the surgery involving a combined laparoscopic and transurethral approach to excise the endometriotic nodule together with partial cystectomy of the bladder. The surgery was carried out by two gynaecological laparoscopic surgeons and a urologist. This video is a good demonstration of the multidisciplinary approach that is required for such a complex case. The surgery itself is technically difficult as the nodule is densely adherent to both bladder and uterus. This video was presented at the 2011 International Urogynecological Association 36th Annual Meeting in Portugal. Endometriosis involving the urinary tract is rare and only occurs in approximately 1% of all patients with endometriosis (Schneider et al., Int J Urol 13:902-904, 2006). Surgery often involves a multidisciplinary approach and the surgery itself is technically challenging. This video is a good example of such a case.