Original article
Relationship between site and size of bladder endometriotic nodules and severity of dysuria

Presented at the 34th annual meeting of the AAGL, Las Vegas, Nevada, November 6–9, 2006.
https://doi.org/10.1016/j.jmig.2007.04.015Get rights and content

Abstract

Study objective

The purpose of this study was to evaluate the relationship between frequency/severity of dysuria with anatomic location and diameter of bladder endometriotic lesions.

Design

Retrospective analysis (Canadian Task Force classification II-3).

Setting

Tertiary care university hospital.

Patients

Forty-one patients with bladder endometriosis (endometrial glands and stroma microscopically diagnosed to infiltrate the muscularis propria).

Interventions

Laparoscopic partial cystectomy, preoperative scoring of dysuria using 10-point verbal analog scale (VAS).

Measurements and main results

Records of all patients with bladder endometriosis were assessed for frequency/severity of preoperative dysuria, anatomic location (base or dome), and diameter of bladder endometriotic nodule. Basal bladder lesions were observed in 18 (43.9%) of 41 patients versus 23 (56.1%) of 41 in the dome. Of the patients with basal lesions, 14 (77.8%) of 18 had preoperative dysuria versus 8 (34.8%) of 23 with dome lesions. Mean VAS score was 8.5 ± 2.37 and 5.75 ± 1.91 for base and dome lesions, respectively. Preoperative dysuria was found in 22 (53.7%) of 41 patients. Mean lesion diameter in patients with dysuria was 25.0 ± 12.6 mm versus 16.3 ± 6.8 mm in patients without dysuria.

Conclusion

Frequency and severity of preoperative dysuria were significantly higher in patients with basal endometriotic nodules. There was a positive correlation between severity of dysuria and lesion diameter.

Section snippets

Study population

Between January 2001 and June 2005, a continuous series of 526 patients underwent laparoscopic treatment for pelvic endometriosis in the minimal invasive surgery unit of S. Orsola University Hospital, a tertiary referral center for treatment of endometriosis. For these patients, medical, gynecologic, and operative records were retrospectively reviewed (G.V., M.M.) and assessed to identify cases with DIE of the bladder. Diagnosis was considered confirmed when endometrial glands and stroma were

Results

Of the 526 patients eligible for the study, 92 patients with endometriosis located solely in the serosa were not included in the study population. Forty-one patients (7.8%) were confirmed microscopically to have bladder endometriosis and were enrolled in our retrospective series. Clinical characteristics of the subjects recruited are reported in Table I.

Endometriotic lesions at the base of the bladder were observed in 18 (43.9%) of 41 patients versus in 23 (56.1%) at the dome. No patients had

Discussion

Although pain is a very important aspect of endometriosis, little is known about the relationship among type and site of endometriotic lesions, disease stage, and severity of pain.14 Deep infiltrating endometriosis is the only macroscopic type of endometriosis for which the relationship with chronic pelvic pain symptoms appears to be well understood.10

The main objective of the present study was to ascertain whether there is a relationship among dysuria (as a probable location-indicating pain)

References (17)

There are more references available in the full text version of this article.

Cited by (53)

  • Symptoms and Surgical Technique of Bladder Endometriosis: A Systematic Review

    2022, Journal of Minimally Invasive Gynecology
    Citation Excerpt :

    It was not possible to calculate the percentage because some studies do not determine the exact number of patients submitted to each BE resection technique. Most of the studies choose to use absorbable polyglactin threads—3-0 [10,19,24,25,27–29,36] or 2-0 [7,15,16,19,21,22,29,34,36]—to suture the bladder defect. Only Walid and Heaton [23] used chromic threads 3-0 and 2-0 for the suture, and 5 studies choose a monofilament thread [17,20,33,35,37].

  • Bladder Endometriosis: A Systematic Review of Pathogenesis, Diagnosis, Treatment, Impact on Fertility, and Risk of Malignant Transformation [figure presented]

    2017, European Urology
    Citation Excerpt :

    Dysuria, frequency, bladder pain, and, less commonly, hematuria, urgency, and urinary incontinence are symptoms related to the presence of BE [3,4,18,38,39]. Dysuria has been reported in 21–69% of patients with BE [3,4,8,38] and positive correlation was observed between severity and lesion diameter [38]. Hematuria is a less frequent symptom, reported in 0–35% of the cases [3,4,8]; this is explained by the fact that the bladder lesion rarely infiltrates the mucosal layer.

View all citing articles on Scopus

The authors have no commercial, proprietary, or financial interest in the products or companies described in this article.

View full text