Bladder Endometriosis: What do we know and what is left to find out? A narrative review

• Published in: Best practice & research. Clinical obstetrics & gynaecology 2024-09, Vol.96, p.102536, Article 102536
• Main Authors: Fleischer, Kyle, Bachi, Averyl, Kam, Jonathan, Narayanan, Priya, Nair, Rajesh, Khazali, Shaheen
• Format: Article
• Language: English
• Subjects: Bladder endometriosis; Endometriosis; Excision surgery; Gynaecology; Pelvic pain; Surgery
• ISSN: 1521-6934; 1532-1932; 1532-1932
• DOI: 10.1016/j.bpobgyn.2024.102536

Bladder endometriosis accounts for 70–85% of urinary tract endometriosis cases. Urinary tract endometriosis occurs in approximately 1% of those living with endometriosis. Underlying aetiology and pathogenesis are not fully understood, but there are several plausible theories. As well as the typical pain symptoms, those with bladder endometriosis can experience several urinary tract symptoms. The manifestation of these symptoms can have complex pathways and processes. Imaging is accurate in the diagnosis of bladder endometriosis and clinicians should be mindful of the risk of silent kidney loss. Management should be guided by symptoms; both medical and surgical options are feasible. Surgical management offers potentially definitive treatment. Excisional surgery via bladder shave or partial cystectomy offers good improvement in symptoms with relatively low rates of serious complications and recurrence. •Bladder endometriosis is the most common location of urinary tract endometriosis.•Symptoms include dysuria, haematuria and storage/voiding dysfunction.•Diagnosis can be challenging and a high index of suspicion is required.•Clinicians should be mindful of the risk of silent kidney loss due to urinary tract obstruction.•Complete surgical excision offers improvement in symptoms with low rates of reported recurrence.