Bowel and bladder endometriosis are two of the most commonly misdiagnosed forms of endometriosis. This is because many of their symptoms can mimic those of several other conditions, including acute appendicitis, inflammatory bowel disease, irritable bowel syndrome, painful bladder syndrome, and celiac disease, just to name a few. Complicating matters further, these other conditions can co-exist with endometriosis. To help provide clarity among such clinical confusion, we’ve compiled the following summary to help you recognize what may be symptoms of bladder and/or bowel endometriosis from those of other disorders.
1. WHAT ARE THE SIGNS AND SYMPTOMS OF BLADDER ENDOMETRIOSIS?
Bladder endometriosis occurs when endometrial-like cells grow on or through the walls of the bladder. The symptoms are often nonspecific, meaning that diagnosis is sometimes difficult. However, the most common symptoms include frequent urination, pain on urination, urinary urgency and urinary retention. In rare cases, patients can have bloody urine during their menses. While these symptoms may occur only during your menstrual cycle, many patients experience these symptoms chronically, any time during the month.
2. HOW IS BLADDER ENDOMETRIOSIS DIAGNOSED?
Bladder endometriosis is diagnosed by biopsy, where a portion of the endometrial implant is sampled from inside the bladder. In order to obtain the sample, a procedure called cystoscopy is first performed, where a camera is placed in the bladder in order to visualize the lesion and bladder anatomy. This allows for accurate sampling. Cystoscopy will also help to rule out other causes of bladder symptoms, such as interstitial cystitis or rarely, bladder cancer.
Interstitial cystitis is a chronic pain condition of the bladder and can also cause pelvic pain and urinary symptoms similar to endometriosis. Patients can have both interstitial cystitis and endometriosis. Therefore, it is important to perform cystoscopy on all patients with bladder symptoms to make these diagnoses because the treatment for these conditions is very different.
3. HOW IS BLADDER ENDOMETRIOSIS TREATED?
The treatment for bladder endometriosis is similar to that of pelvic endometriosis. It can be managed with hormonal regulating medications. However, for definitive treatment, the endometriosis needs to be surgically removed. Because endometriosis usually involves the full thickness of the bladder, a portion of the bladder wall usually needs to be removed. Consult today with the expert Dr. Azer if you have any of these symptoms.
4. CAN BLADDER ENDOMETRIOSIS BE TREATED BY MINIMALLY INVASIVE TECHNIQUES?
Yes, but only by an experienced surgeon. To resect a portion of the bladder and repair the bladder by robotic-assisted laparoscopy requires a high level of skill with those instruments. As mentioned, Dr.Azer with nearly 2 decades of using the da Vinci robot (since it was FDA approved) has now performed among the most endometriosis surgeries including bladder and bowel endometriosis.
