Endometriosis: A Rare Cause of Gross Hematuria

Abstract

Introduction: Endometriosis is a condition in which endometrial tissue exists outside the uterine cavity. Urinary tract lesions are present in 1 % of women with this condition. Case Presentation: A 34-year-old woman was presented to our clinic with a 3-year history of dysuria and frequency. Her past medical history was significant for cesarean sections, performed 3 years earlier. In our center, the patient underwent cystoscopy and transurethral resection of a lesion found in the bladder wall, which on histopathology examination appeared to be endometriosis. A course of six-month hormonal therapy with luteinizing hormone-releasing hormone (LHRH)-agonist (Dipherelin™ 3.75 IM per 28 day) was planned for her. One month later, trans-vaginal ultrasound revealed a nodule posterior to the bladder, which had grown 1 cm in the preceding month. Therefore, Hysterectomy, bilateral oophorectomy, and partial cystectomy were performed. The pathology report was Mullerianosis. During two years of follow up, the patient remained asymptomatic. Conclusions: Endometriosis and endocervicosis should be regarded as important differential diagnoses in patients with gross hematuria and those suspected to have urothelial carcinomas.