Bladder endometriosis: what it is, symptoms, exams and treatment

Bladder endometriosis is when endometrial tissue grows outside the uterus, in this specific case, on the walls of the bladder. However, unlike what happens in the uterus, where this tissue is eliminated during menstruation, the endometrium that is on the walls of the bladder has nowhere to go, generating symptoms such as pain in the bladder, burning sensation when urinating or frequent urge to urinate, especially during menstruation.

The occurrence of endometriosis in the urinary tract is rare, being found in 0.5% to 2% of all cases, but it normally occurs in women of childbearing age.

Bladder endometriosis has no cure, however, treatment with surgery or hormonal medications can help alleviate symptoms, especially in women with very intense symptoms of the disease.

Main symptoms

Symptoms of endometriosis in the bladder are:

• Discomfort when urinating;
• Pain in the pelvic region, kidneys or bladder region, which worsens with menstruation;
• Painful sexual intercourse;
• More frequent trips to the bathroom to urinate;
• Presence of pus or blood in the urine, especially during menstruation;
• Excessive tiredness;
• Persistent fever below 38ºC.

The symptoms are not very specific and, therefore, end up being confused with menstrual period pain.

When there are recurring symptoms, but no other causes are identified, such as urinary tract infections, the doctor may suspect endometriosis and, therefore, tests such as videolaparoscopy may be ordered to look for endometrial tissue in the bladder, confirming the diagnosis.

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Tests to confirm endometriosis

Videolaparoscopy is the most commonly used test to diagnose endometriosis in the bladder. In this examination, the pelvic organs, including the bladder and ureters, are observed in order to identify foci of endometrial tissue or changes caused by endometriosis.

However, before this exam, the doctor may also try to identify any changes through less invasive exams such as pelvic ultrasound or MRI, for example.

How the treatment is carried out

Treatment for bladder endometriosis depends on age, desire to have children, intensity of symptoms and severity of the lesions. However, the most used ducts are:

• Hormonal therapywith medicines similar to the pill, which reduce the production of endometrium in the bladder;
• Surgery for total or partial removal of the bladder, whether or not it may be necessary to remove one or both ovaries;
• Both treatmentsdepending on the severity of the disease.

The consequences of endometriosis in the bladder, when not treated correctly, are the occurrence of more serious urinary problems in the future, such as obstruction or urinary incontinence.

Can bladder endometriosis cause infertility?

Generally, endometriosis in the bladder does not affect a woman’s fertility, however, as there is an increased risk of also having endometriosis in the ovaries, some women may have greater difficulty getting pregnant, but this is only related to the change in the ovaries.