Laparoscopic Management of Endometriosis with Deep Infiltration of the Bladder

Abstract

Study Objective To discuss and review surgical management of endometriosis with bladder invasion through a surgical case. Design Single patient case report. Setting Academic hospital. Patients or Participants 38yo G3P3 with pelvic pain, dysuria, adenomyosis and urinary tract endometriosis desiring definitive management. Interventions Patient underwent robotic-assisted laparoscopic lysis of adhesions, resection of urinary tract endometriosis with bladder dome involvement and hysterectomy. During resection, paravesical and vesicouterine spaces were developed, the ureter was identified, and the bladder dome lesion circumscribed and excised, followed by detrusor repair. Measurements and Main Results The patient was discharged home the same day with a urinary foley catheter for two weeks. She had an uncomplicated post-operative course with improvement in her symptoms. Conclusion This video demonstrates the robotic resection of deep infiltrating endometriosis with urinary tract involvement and highlights techniques to avoid injury to underlying structures. To discuss and review surgical management of endometriosis with bladder invasion through a surgical case. Single patient case report. Academic hospital. 38yo G3P3 with pelvic pain, dysuria, adenomyosis and urinary tract endometriosis desiring definitive management. Patient underwent robotic-assisted laparoscopic lysis of adhesions, resection of urinary tract endometriosis with bladder dome involvement and hysterectomy. During resection, paravesical and vesicouterine spaces were developed, the ureter was identified, and the bladder dome lesion circumscribed and excised, followed by detrusor repair. The patient was discharged home the same day with a urinary foley catheter for two weeks. She had an uncomplicated post-operative course with improvement in her symptoms. This video demonstrates the robotic resection of deep infiltrating endometriosis with urinary tract involvement and highlights techniques to avoid injury to underlying structures.