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  • Laparoscopic Excision of Urinary Bladder Endometriosis with repair
    Dr Uddhavraj Dudhedia Dr Manek Potwar Dr Devki Potwar
    Minimal Access Gyn-oncological, Neuropelvic, and Urogynaecological surgery
    St. Elizabeth Hospital, Mumbai, India

    Clinical Details: 29 years old lady with chief complaints:

    1. difficulty in conceiving since 3 years
    2. Severe dysmenorrhea since 3 -4 years
    3. Episodes of hematuria during periods since 3-4 months
    4. Pain in lower abdomen, persisting after periods

    Ultrasound pelvis suggested:
    Bulky uterus, with ,mass at the isthmic region, indenting the bladder, measuring approximately 4X4 cm, bilateral ovarian masses s/o endometriomas ( 4×4 cm size each approx..)

    MRI pelvis suggested:
    Nodule invading bladder muscle and mucosa, more on the left side, and arising from the cervico-isthmic region. Bilateral ovarian endometriomas confirmed as well.

    Procedure: Operative Laparoscopy, cystoscopy, followed by bilateral ureteric stenting, excision of bladder endometriosis, cystoplasty, with excision of bilateral ovarian endometriomas, with hysteroscopy and chromopertubation.

    Post-Operative Course:
    Ureteric stents were removed intra-operatively, after the bladder repair.
    Patient mobilized in the evening.
    She accepted liquids, followed by full diet within 24 hours.
    She was discharged after 48 hours.
    Bladder catheter was kept for 2 weeks.
    Patient recovered well, with no complaints.
    She was advised GnRH analogues, and referred to a fertility physician.