Bladder endometriosis is due by the infiltration of the bladder wall through the peritoneum and the connective tissue of the vesico- uterine space. For this reason is not correct to treat this pathology only with a resection via cystoscopy. Sometimes is concurrently present an adenomyosis of the anterior wall of the uterus.
The steps for a correct surgery of this pathology are:
Dissection of the vesico-uterine space.
Opening the bladder just above the endometriotic nodule.
Complete resection of the nodule.
Suturing the bladder in two layers with running sutures.
Remove all the endometriotic and adenomyotic tissue on the anterior wall of the uterus.