Ultrasound Investigation of Scar Endometrioma in a Patient with Bladder Exstrophy
Case Report
Abstract
Extra pelvic forms of endometriosis is common, however, endometriosis after bladder exstrophy surgery has rare been reported, and here we present one of the first reported case. A 32-year-old woman with a history of bladder exstrophy was aware of a painful induration at the operative scar located in the mid lower abdominal wall, and presented at an Australian hospital. She had had endometriosis in 2011 and she was managed with medical treatment. When she was born underwent surgery in Recife, Pernambuco – Brazil. She was followed-up for more than 25 under the care of a pediatric surgeon. She had several urinary infection and partial incontinence. Otherwise she was a normal woman with boyfriend. She went to college and graduate in architecture. She moved to Australia two years ago and is being follow-up by urologist. Her main concern is her partial urinary incontinence and the willing of being pregnant. In the past two weeks she presented with increasingly colic abdominal pain, which seemed to be located under the lower abdominal scar. Her abdominal ultrasound investigation revealed “There is a solid lesion demonstrating mild internal vascularity in the lower anterior abdominal wall, deep to the surgical scar and 6 cm inferior to the umbilicus. This could represent an endometrioma”. She has been managed with medical approach. The desire of sexual intercourse and pregnancy is being discussed. Artificial insemination is other way of fulfilling motherhood dream.References
Kitajima T, Inoue M, Uchida K, Otake K, Kusunoki M. Scar endometriosis in a patient with bladder exstrophy. Int Surg. 2013; 98(2):145-8. doi: 10.9738/INTSURG-D-12-00011.1.
Horton JD, Dezee KJ, Ahnfeldt EP, Wagner M. Abdominal wall endometriosis: a surgeon’s perspective and review of 445 cases. Am J Surg 2008;196(2):207–212
Sedhain N, Dangal G, Karki A, Pradhan HK, Shrestha R, Bhattachan K, Poudel R, Bajracharya N. Caesarean scar endometriosis. J Nepal Health Res Counc. 2018;15(3):292-294.
Merlot B, Ploteau S, Abergel A, Rubob C, Hocke C, Canis M, Fritel X, Roman H, Collinet P. Extragenital endometriosis: Parietal, thoracic, diaphragmatic and nervous lesions. CNGOF-HAS Endometriosis Guidelines. Gynecol Obstet Fertil Senol. 2018. pii: S2468-7189(18)30033-3. doi: 10.1016/j.gofs.2018.02.001
Somigliana E, Vercellini P, Gattei U, Chopin N, Chiodo I, Chapron C. Bladder endometriosis: getting closer and closer to the unifying metastatic hypothesis. Fertil Steril 2007;87(6):1287–90.
Donnez J, Spada F, Squifflet J, Nisolle M. Bladder endometriosis must be considered as bladder adenomyosis. Fertil Steril 2000;74(6):1175–81
Fedele L, Piazzola E, Raffaelli R Panazza S, Cortesi I, Crosignani PG. Bladder endometriosis: deep infiltrating endometriosis or adenomyosis? Fertil Steril 1998;69(1):972–75.
Vercellini P, Meschia M, De Giorgi O Panazza S, Cortesi I, Crosignani PG. Bladder detrusor endometriosis: clinical and pathogenetic implications. J Urol 1996;155(1):84–6.
Donne C, Vidal M, Buttin X, Becerra P, Carvia R, Zuluaga A. Mullerianosis of the urinary bladder: clinical and immunohistochemical findings. Histopathology 1998;33(3):290–92.
Olivia Vella JE, Nair N, Ferryman SR, Athavale R, Latthe P, Hirschowitz L. M̈ullerianosis of the urinary bladder. Int J Surg Pathol 2011;19(4):548–51.
Koren J, Mensikova J, Mukensnabl P, Zamecnik M. Mullerianosis of the urinary bladder: report of a case with suggested metaplastic origin. Virchows Arch 2006; 449(2):268–71.
Kaufman MR. Pelvic Organ Prolapse and pregnancy in the female bladder exstrophy patient. Curr Urol Rep. 2018;19(3):18. doi: 10.1007/s11934-0180767-2.
Deans R, Liao LM, Wood D, Woodhouse C, Creighton SN. Sexual function and health related quality of life in women if classic bladder exstrophy. BJU Int 2015;115:633-38.
Da Cruz JA, de Mattos B, Srougi M, Nguvenh H, Passerotti C, Bonan R, Denes F, Giron A. Quality of life in Young adults patiens treated for bladder exstrophy. Cent European J Urol. 2016;69:221-24. Doi: 10.5173/ceju.2016.715.
Rubenwolf P, Thomas C, Thüroff JW, Stein R. Sexual function and fertility of women with classic bladder exstrophy and continent urinary diversion. J Urol. 2016; 196(1):140 –5.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access at http://opcit.eprints.org/oacitation-biblio.html).
