Easy Steps for Excision of a Deep Infiltrative Endometriotic Bladder Nodule

Background: Eighty-five percent of the time that endometriosis is found in the urinary tract, the condition is found on the bladder itself. Common symptoms include dysuria, hematuria, urinary urgency, and bladder pain. These symptoms may worsen with menstruation. This article presents a patient with signs and symptoms of bladder endometriosis. Imaging revealed a bladder nodule and other lesions suspicious for endometriosis. The patient opted for surgical management. The surgical solution was to excise the bladder nodule by creating a cystotomy and repairing the bladder using a two-layer closure technique. Given that the patient presented with a compilation of several bladder symptoms and imaging showed a bladder nodule, she was an optimal candidate for surgical intervention. Technique: The technique described in this article is an efficient and effective method of excising a deep infiltrative endometriotic (DIE) bladder nodule. A video (Supplementary Video. SV1; Supplementary Data are available online at www.liebertonline.com/GYN) demonstrates the steps of a DIE bladder-nodule excision. This is a simple and reproducible technique for all gynecologic surgeons who manage endometriosis. Conclusions: A total excision of a DIE bladder nodule is an effective treatment modality for patients with pelvic pain and suspected bladder endometriosis. Supplementary Video SV1 highlights reproducible steps that can be performed easily by gynecologic surgeons when encountering a DIE bladder nodule. (J GYNECOL SURG 39:198)