Endometriosis with pure urinary symptoms.

Received January 2008 Accepted July 2008 INTRODUCTION Endometriosis is defined as abnormal growth of the endometrial glands and stroma beyond the normal confines of the uterus. Although the condition is usually limited to the ovaries, uterosacral ligaments, and Douglas’ pouch, it has been reported in almost every organ of the body. A total of 10% to 20% of women in reproductive ages may be affected. Endometriosis may involve the urinary tract, and the most common site of involvement in this system is the bladder.(1) Urinary presentation of pelvic endometriosis without previous genital symptoms is very rare.(1,2) In this report, a case of initial urinary presentation of pelvic endometriosis is described. CASE REPORT A 38-year-old woman with 2 children (the 1st child born via normal vaginal delivery, and the 2nd, by cesarean) presented with abdominal pain, urgency, and frequency during the period of menstruation since her second delivery. She had no hematuria, flank pain, or history of urinary calculi. Pelvic examination revealed no abnormal finding, and no palpable mass was detected. However, abdominal ultrasonography revealed a 31 × 14 × 11-mm mass in the posterior bladder wall (Figure 1). Transvaginal ultrasonography demonstrated a hypoechoic 29×13-mm node in the posterior bladder wall on the site of cesarean section incision, suggesting endometrioma (Figure 2). On