Patient with a history of hiatal hernia and two cesarean sections at 22 and 24 years.
At 31 years of age she consulted to refer from the second cesarean section and with increasing intensity, symptoms of voiding syndrome, accompanied by pelvic and perineal pain in the days before, during and after menstruation.
He did not report hematuria or fever.
Examination of the external genitalia and abdomen showed no abnormalities.
It was treated on multiple occasions with urinary antiseptics, although never demonstrated positive urolithiasis.
The renal echography was normal and at the bladder level an excrecent image, hyperechogenic 1.5 cm was observed in the posterior face. The cystoscopy was performed in the middle of the menstrual cycle, describing the existence of endometriosis with minimal
The patient was lost to follow-up for 3 years, during which she continued to have the same symptoms, being treated by her gynecology who diagnosed foci endometrial walls and pelvic bladder solidary not appreciated by laparoscopy.
The patient came back to our service with ultrasound and CT.
Abdominal and transvaginal ultrasound showed echogenic formation in the bladder floor 2 x 1.5x2.7.
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No pathology was observed in abdominal organs at the level of the sentinel node in the bladder, with the presence of a mass of 2x3 cm in the posterior face without a clear differentiation plan with the uterus.
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At the age of 34 years and with suspected endometriosis bladder endoscopy was performed under anesthesia a few days before menstruation, mass with a morular aspect of about 3 cm, blue retrotrigonal, with slightly edematous mucosa.
TURP was performed, showing the dissection with the loop small cavities, which corresponded to cystic endometrial glands, of which the court kept retained blood in form.
The histopathological study confirmed the presence of intramuscular nests of endometrial glands surrounded by edematous endometrial stroma, without signs of malignancy, all of which is compatible with the diagnosis of endometriosis.
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The patient was treated with LH-RH analogues for 6 months.
Five years later she is completely asymptomatic and with several bladder ultrasounds and two cystoscopy during this period without evidence of recurrence.
