Diagnóstico incidental de endometriosis vesical / Incidental diagnosis of vesical endometriosis

INTRODUCCIÓN: La afectación del sistema urogenital por la endometriosis es infrecuente, la vejiga es el órgano más dañado. Se manifiesta clínicamente con urgencia miccional, polaquiuria, dolor hipogástrico, hematuria y, en ocasiones, es causa de infertilidad. OBJETIVOS: Presentar un nuevo caso de endometriosis vesical así como su diagnóstico y tratamiento. MÉTODOS: Paciente de 24 años de edad con antecedentes de buena salud que asistió a la consulta de Ginecología por dolor persistente en bajo vientre, en los días previos a la menstruación, de varios meses de evolución. Refería también ligero esfuerzo miccional inicial. El examen físico del abdomen y los genitales, internos y externos, era normal. En el ultrasonido abdominal se informaron dos lesiones tumorales de aspecto quístico a nivel del trígono vesical, las cuales se confirmaron en el estudio vía transvaginal. RESULTADOS: En la cistoscopia se constataron las tumoraciones a nivel de la barra interuretérica las cuales se resecaron con el asa de corte. El informe anátomo-patológico de la pieza quirúrgica fue endometriosis vesical. En la laparoscopia se constató otro foco de endometriosis en el fondo de saco de Douglas. Se le puso tratamiento específico con mifepristona 5 mg diarios por 6 meses y ha evolucionado satisfactoriamente; el estudio ultrasonográfico y la cistoscopia de control semestrales fueron negativos. CONCLUSIONES: La realización del ultrasonido abdominal y transvaginal, en pacientes en edad fértil con dolor pelviano recurrente de origen no precisado, con o sin síntomas urinarios asociados, posibilita el diagnóstico y el tratamiento precoces de la endometriosis vesical

INTRODUCTION: The urogenital system affection from endometriosis if uncommon where the more involved organ is the bladder. Its clinical manifestations are a urgent miction, pollakiuria, hypogastric pain, hematuria and occasionally is a cause of infertility. OBJECTIVES: To present a new case of vesical endometriosis as well its diagnosis and treatment. METHODS: This is the case of female patient aged 24 with a history of good health came to Gynecology consultation due to persistent pain in lower stomach previous days to menstruation of several months of course, as well an initial miction effort .Physical examination of abdomen and genital internal and external organs was normal. In abdominal US were informed two tumor lesions of cystic appearance at vesical trigone level, which were verified through a transvaginal study. RESULTS: During cystoscopy tumor were at ureteric bar, which were resected with cut loop. The report of anatomical-pathological report of surgical sample was a vesical endometriosis. At laparoscopy appeared an endometriosis focus in Douglas's cul-de-sac. Treatment with 5 mg daily of Mifepristone for 6 months with a satisfactory evolution; US study and six-monthly control cystoscopy were negative. CONCLUSIONS:The abdominal and transvaginal US carrying out in patient of fertile age with recurrent pelvic pain ion not-defined origin, with or without associated urinary symptoms, allow the early diagnosis and treatment of vesical endometriosis

Diagnóstico y tratamiento de la endometriosis vesical / Diagnosis and treatment of vesical endometriosis

La endometriosis consiste en la presencia de tejido endometrial activo, fuera de la cavidad uterina. Afecta a la mujer preferentemente en el período premenopáusico y en muchas ocasiones, es causa de infertilidad. Su localización en el aparato urinario es infrecuente; la vejiga es el órgano más dañado seguida por los uréteres. En el presente trabajo se realizó la actualización del tema de la endometriosis vesical en lo referente a diagnóstico y tratamiento. Para ello se efectuó una búsqueda bibliográfica en las bases de datos de Hinari y Medline. Se evidencia la importancia de tener presente esta entidad nosológica, en el diagnóstico diferencial de la paciente, en edad fértil, que asiste a consulta por dolor pelviano crónico de origen no precisado. De esta forma y con la utilización rutinaria del ultrasonido transvaginal en estos casos, se haría el diagnóstico precoz y se aplicaría el tratamiento oportuno, de los cuales la modalidad combinada, quirúrgica de mínimo acceso y hormonal, es la más utilizada en la actualidad

The endometriosis is the presence of active endometrial tissue outside the uterine cavity affecting mainly to woman during the menopause and frequently is the infertility cause. Its location in the urinary tract is infrequent; the bladder is the organ more damaged by ureter. In present paper an update on the vesical endometriosis was carried out concerning the diagnosis and treatment. Thus, we made a bibliographic search in databases Hinari and Medline. It is very important to take into account this disease entity in the differential diagnosis of patient in fertile age, attending to consultation due to chronic pelvic pain of not specified origin. In this way and with the systematic use of transvaginal ultrasound in these cases, it will be possible to made an early diagnosis and will be applied a timely treatment from which the combined modality, the minimal access surgery and hormonal therapy is the more used nowadays

A Case of Vesical Endometriosis / 대한비뇨기과학회지

Endometriosis is the presence of normal endometrial tissue in an ectopic location. Its involvement of urinary tract occurs in up to 10 percent. Especially the incidence of vesical endometriosis is very rare. We report one case of vesical endometriosis that have been treated by partial cystectomy and then discussed with references to its unusual features management.

Vesical Endometriosis : A Review and 1 Case Report / 대한비뇨기과학회지

The term endometriosis refers to ectopic endometriume. It most often involves the pelvic organs, including ovaries, broad and round ligaments, fallopian tubes, cervix, vagina and the pouch of Douglas. We report a case of vesical endometriosis in a 4- year old female patient and review literature. Segmental resection of this mass with involved bladder resulted in cure and this lesion was confirmed histologically as endometriosis of the bladder.

A Case of Vesical Endometriosis / 대한비뇨기과학회지

We report a case of vesical endometriosis in a 34 year old female patient and review literature. Managements include partial cystectomy, hormonal treatment and radiation. In this case, we select the hormonal treatrnent because the vesical endometriosis was in the fixed portion of the bladder.