Complex Endometriosis Center

Deep endometriosis lesions invading the bladder usually cause sensations of urinary infection during menstruation. We will discuss here deep endometriosis lesions invading the bladder (muscular and mucous membrane) and we will not discuss here superficial lesions of the peritoneum covering the bladder, the treatment of which is described in the section on peritoneal endometriosis

In addition to pelvic MRI, exploration of the bladder (cystoscopy) is usually required to assess the distance between a deep endometriotic lesion and the bladder outlet of the ureters, as well as their submucous course. If the lesion is remote from the ureteral outlet, the bladder lesion and transfixing portion of the bladder are excised, then sutured. In order to ensure complete healing of the suture, a urinary catheter should be worn postoperatively for a period of 10 to 14 days at home. Use of a urine collection bag during the day and night is fully explained at the operative consultation and patients can only return home once they have mastered its use, which usually happens very quickly. It is then removed at home by a qualified nurse.

If the endometriotic lesion is close to the end of the ureters, suturing the bladder may be more tricky. In such circumstances, the surgeon may propose placement of a JJ stent, which makes it easier to locate the transparietal course of the ureter. These JJ catheters are placed prior to surgery by specialized urological surgeons because their insertion requires general anesthesia, while their removal is done on an outpatient basis.