The patient was a 31-year-old woman with a history of hysterectomy, allergy to penicillins, two normal pregnancies, with a normal delivery at 18 years of age, a curettage abortion at 22 years and a cesarean at 24 years.
The patient reported dysmenorrhea ever since.
In a gynecological review and with normal exploration, ultrasound showed normal genital tract, and an excretory image in the posterior bladder of two centimeters, suggestive of bladder tumor.
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Cystoscopy showed a polypoid neoformation with cystic areas, with a slight blue dye of two cm in diameter, located slightly above and to the left of the left ureteral orifice.
TUR of the neoformation was performed, describing the histopathology as: Fragments of the bladder wall coated by urothelium without relevant changes.
In the lamina propria and in the underlying muscle there are glandular structures, dispersedly distributed, without signs of atypia, which mimic endometrial glands, surrounded by endometrial stroma as well.
Sometimes the epithelium of the glands is endocervical mucous type, or it is cuboid or cydrical polyposis.
There is focal accumulation of macrophages with intracytoplasmic brown pigment.
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Subsequently, the patient was managed by gynecologists, although no treatment was prescribed, with several gynecological and bladder ultrasounds and pelvic MRI showing no pelvic or bladder pathology.
Nine years after TURP, the patient remains asymptomatic, although she still has dysmenorrhea, with severe pelvic pain in the last two days of menstruation.
In recent gynecological controls with transvaginal ultrasound and pelvic MRI, no pathology was observed.
