[Intravesical salpingiosis: case report and review of the literature].

Abstract:

:Endosalpingiosis of the urinary bladder is a rare benign condition characterised by the presence of ectopic endosalpingeal tissue in the bladder. If histology shows two or more Müllerian-derived components, this condition is referred to as Müllerianosis.To our knowledge less than 20 cases of Müllerianosis and 5 cases of endosalpingiosis have been documented in the literature.Although the pathogenesis remains unclear, two theories exist. The implantation theory assumes that Müllerian-derived tissue gets implanted in the wall of the urinary bladder during pelvic surgery. The second theory proposes a metaplastic origin of the disease.Patients suffering from endosalpingiosis or Müllerianosis may present with symptoms such as suprapubic pain, frequent urination, dysuria or gross haematuria, possibly with a cyclical appearance.We present the case of a 40-year-old female patient, who primarily presented with painful haematuria and was diagnosed with endosalpingiosis and treated by transurethral resection. Also we review the current literature. :Die Endosalpingiose der Harnblase ist eine sehr seltene benigne Erkrankung der Harnblase gekennzeichnet durch das ektope Auftreten von endosalpingialem Gewebe. Das zusätzliche Vorliegen von endozervikalem oder endometrialem Gewebe wird als Müllerianose bezeichnet. In der englischsprachigen Literatur sind ca. 5 reine Endosalpingiose- und 17 Müllerianosefälle beschrieben. Über die Entstehung der Erkrankung existieren zwei Theorien. Während die Implantationstheorie von der Versprengung ektopen Gewebes durch chirurgische Eingriffe ausgeht, propagiert die Metaplasie-Theorie die Neuentstehung durch einen vermeintlichen hormonellen Einfluss. Die Symptomatik der Erkrankung ist ebenso vielfältig wie unspezifisch und kann eine Drangsymptomatik, suprapubische Schmerzen, aber auch Dysurie oder Makrohämaturie beinhalten. Die Beschwerden können zudem zyklisch und zyklusabhängig auftreten.Die Diagnosestellung wird aufgrund der Seltenheit weitestgehend ein Zufallsbefund im Rahmen der zystoskopischen Abklärung dieser Beschwerden bleiben. Eine adäquate Therapie gelingt in der Regel mittels transurethraler Resektion. Allerdings kann es auch bei scheinbar vollständiger Resektion zu Rezidiven kommen, welche zum Teil eventuell einen invasiveren Eingriff nach sich ziehen können.Wir präsentieren die Kasuistik einer 40-jährigen Patientin mit schmerzhafter Makrohämaturie, bei der zufallsbefundlich eine intravesikale Salpingiose nachgewiesen und die in unserer Klinik mittels transurethraler Resektion behandelt wurde. Zudem geben wir einen Überblick über die vorliegende Literatur dieser seltenen intravesikalen Raumforderung.

journal_name

Aktuelle Urol

journal_title

Aktuelle Urologie

authors

Gilbert N,Guo X,Bauer J,Hennig M,Kümpers C,Merseburger AS

doi

10.1055/s-0043-110039

subject

Has Abstract

pub_date

2018-06-01 00:00:00

pages

266-268

issue

3

eissn

0001-7868

issn

1438-8820

journal_volume

49

pub_type

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