Laparoscopic partial bladder resection for bladder endometriosis

Objectives To confirm the feasibility and safety of laparoscopic partial bladder excision. Setting Gynaecology department at a university hospital. Subjects Two patients with symptomatic bladder endometriosis. Interventions Ureteral catheterization, peroperative cystoscopy, laparoscopic adhesiolysis, bladder dissection, partial cystectomy, bladder closure with running sutures and simultaneous treatment of other endometriotic lesions. Results The procedures were uncomplicated and, took 120 and 105 min, respectively. Bowel function recovery occurred within 24 h in both cases. The Foley catheters were withdrawn on days 10 and 7. Histological examination showed endometriosis. The patients are free of symptoms at 11 and 6 months of follow up. Conclusions This technique is feasible and safe and allows simultaneous treatment of other endometriotic lesions. Peroperative cystoscopy and ureteral catheterization are recommended to precisely define the lesion limits and to avoid trapping the ureters in the suture. In trained hands, this technique may become the treatment of choice for bladder endometriosis. Further evaluation will help to determine which instruments and types of sutures are best suited to laparoscopic bladder surgery.