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Robot-assisted partial cystectomy for bladder endometriosis: dual approach involving cystoscopy and robotic surgery
  1. Anupama Bahadur1,
  2. Rajlaxmi Mundhra1,
  3. Poonam Sherwani2 and
  4. Sunil Kumar3
  1. 1Obstetrics and Gynaecology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
  2. 2Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
  3. 3Urology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
  1. Correspondence to Dr Rajlaxmi Mundhra; rmundhra54{at}yahoo.com

Abstract

Bladder endometriosis accounts for 70%–85% cases of urinary tract endometriosis. A high index of suspicion is needed to diagnose this condition as most women have associated pelvic and menstrual complaints. The presence of cyclical haematuria along with tender anterior vaginal wall should alert the gynaecologist or urologist to consider this rare entity. Treatment is medical therapy followed by surgery when needed. Transurethral resection of endometriotic spot is the commonly used approach but to completely excise the endometriotic nodule, bladder resection at the site of nodule is needed along with repair of cut bladder margins. Herein, we describe a dual surgical approach where the margins of the endometriotic spot were delineated and cut using cystoscopy, followed by robotic approach to completely excise the nodule along with bladder repair. Robotic approach seems safer and easier in this complex surgery owing to dense adhesions in such cases.

  • radiology
  • urological surgery
  • haematuria

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Footnotes

  • Contributors AB and RM managed the case. PS assisted with diagnosis. SK along with AB and RM operated the case. AB and RM prepared and revised the manuscript. All authors accepted the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.