Resection of a large endometriotic nodule of the bladder using a combined laparoscopic and cystoscopic approach (“light to light technique”)

K C D P Silva,I G D C Illukpitiya,R P J Sumanathissa,W I Gankanda,N C Abeysekara

doi:10.4038/sljog.v42i4.7939

K C D P Silva, I G D C Illukpitiya + Show 3 more

Open Access

https://doi.org/10.4038/sljog.v42i4.7939

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Abstract

Bladder endometriosis is uncommon yet a cause of cyclical disabling urinary symptoms. Surgical excision of the bladder endometriotic nodule using combined cystoscopic and laparoscopic approach (“light to light technique”) remains the best approach where surgery is deemed the mode of treatment. A 31-year-old infertile woman underwent resection of endometriosis of the bladder by this method. The main surgical steps included ureteric stenting, bladder mobilization, marking the endometriotic nodule cystoscopically, cystoscopic transillumination, completion of the bladder nodule excision laparoscopically and bladder repair.

Highlights

Endometriosis affects 15-20% of women in the reproductive age group
Endometriosis of the urinary tract occurs in about 1-2% of women of which the bladder is the most frequently involved organ
Bladder was opened using laparoscopic monopolar diathermy at the point of cystoscopic puncture and the endometriotic nodule was completely excised laparoscopically along the groove created by the Collins knife (Figure 3)

Summary

Introduction

Endometriosis affects 15-20% of women in the reproductive age group. Endometriosis of the urinary tract occurs in about 1-2% of women of which the bladder is the most frequently involved organ.A31-year-old housewife from Puttalam presented with primary infertility, dyspareunia, dysmenorrhea, dyschezia and bladder pain. Endometriosis affects 15-20% of women in the reproductive age group. Endometriosis of the urinary tract occurs in about 1-2% of women of which the bladder is the most frequently involved organ. The most significant feature was severe pain during micturition which a Senior Lecturer and Head of Department, Obstetrics and Gynaecology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Sri Lanka. B Senior Registrar, Department of Obstetrics and Gynaecology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Sri Lanka.

Results

Conclusion