Infiltrating endometriosis of the urinary bladder mimics lower segment myoma of the uterus

Objective: Bladder endometriosis is a rare disease with variable symptoms. No definite treatment for this disease has been documented due to its rarity. We present a case of bladder endometriosis mimicking a lower segment uterine adenomyoma. Case Report: A 25-year-old woman presented with the complaint of severe dysmenorrhea and suprapubic tenderness of 6 months' duration. Transvaginal ultrasonography showed a lower segment heteroechogenic mass of the uterus. Laparoscopy revealed a mass on the posterior wall of the urinary bladder after dissection of the vesicouterine fold. Cystoscopy confirmed that the lesion was confined to the muscular layer, without involvement of bilateral ureter orifices. Partial cystectomy was performed during exploratory laparotomy. Bladder endometriosis was confirmed by pathology. The patient had an uneventful recovery. The postoperative severity of dysmenorrhea was reduced to half that experienced preoperatively. Conclusion: Women with bladder endometriosis may have no symptoms during urination. A high index of suspicion of bladder endometriosis is necessary when a heteroechogenic mass in the anterior lower segment of the uterus is detected on pelvic ultrasound.