Objective: To present the anatomopathological characteristics of deep bladder endometriosis.
Design: Descriptive anatomapathological study.
Setting: A university hospital department of gynecological surgery.
Patient(s): Eleven consecutive patients complaining of pelvic pain and painful urinary functional symptoms.
Intervention(s): Laparoscopic partial cystectomy.
Main outcome measure(s): Macroscopic and microscopic characteristics of deep bladder endometriosis lesions.
Result(s): Deep bladder endometriosis lesions were extremely heterogeneous, not only in any one patient but also from one patient to another. Bladder muscularis propria presented three aspects: [1] hyperplasia of the fibromuscular tissue (4/11); [2] simple dissociation of the smooth muscle fiber bundles with no veritable "disorganization" (4/11); [3] simple thickening of the interstitial collagen network, or sclerosis (3/11). A histological adenomyotic nodule aspect was only observed in one patient (9%).
Conclusion(s): Bladder endometriosis is an enigmatic disease. No hypothesis can be proposed as a single explanation for its pathogenesis.