- Email: [email protected]
Bladder endometriosis in pregnancy
Journal Pre-proof Bladder Endometriosis in Pregnancy Harrison Banner, MD, MSc, Ally Murji, MD, MPH PII:
S0002-9378(20)30239-8
DOI:
https://doi.org/10.1016/j.ajog.2020.02.048
Reference:
YMOB 13149
To appear in:
American Journal of Obstetrics and Gynecology
Received Date: 16 January 2020 Revised Date:
11 February 2020
Accepted Date: 23 February 2020
Please cite this article as: Banner H, Murji A, Bladder Endometriosis in Pregnancy, American Journal of Obstetrics and Gynecology (2020), doi: https://doi.org/10.1016/j.ajog.2020.02.048. This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. © 2020 Elsevier Inc. All rights reserved.
1
Bladder Endometriosis in Pregnancy
2 3
Harrison Banner, MD, MSc
4
Ally Murji, MD, MPH
5
Mount Sinai Health System, Toronto, Ontario CANADA
6 7
The authors report no conflict of interest.
8 9 10 11
Corresponding Author
12
Harrison Banner, Mount Sinai Health System, Toronto, Ontario CANADA
13
[email protected]
14 15
16
A 37-year-old G3P2, with two prior Caesarean sections, was referred with hematuria in
17
pregnancy. The patient endorsed longstanding dysmenorrhea and catamenial hematuria.
18
Transabdominal ultrasound showed an avascular 4.3x1.7x3.2cm mass arising from the posterior
19
bladder wall (Panel A) with papillary projections extending into the bladder (Panel B and Video).
20
The placenta was fundal. Cystoscopy at 10 weeks gestation confirmed an exophytic mass
21
distorting the bladder trigone. Biopsy was consistent with endometriosis. Mass size and
22
appearance remained unchanged on serial ultrasounds.
23
Repeat cystoscopy at Caesarean confirmed the previous findings (Panel C and Video)
24
with no evidence of other pelvic endometriosis. At 6 weeks post-partum, the patient started
25
oral progestin.
26
Endometriosis is more common in women with previous uterine surgery and should be
27
considered in the differential diagnosis of bladder mass in pregnancy. Biopsy is safe and
28
necessary to exclude malignancy. Masses should be followed serially until they can be safely
29
treated postpartum.
S0002-9378(20)30239-8
DOI:
https://doi.org/10.1016/j.ajog.2020.02.048
Reference:
YMOB 13149
To appear in:
American Journal of Obstetrics and Gynecology
Received Date: 16 January 2020 Revised Date:
11 February 2020
Accepted Date: 23 February 2020
Please cite this article as: Banner H, Murji A, Bladder Endometriosis in Pregnancy, American Journal of Obstetrics and Gynecology (2020), doi: https://doi.org/10.1016/j.ajog.2020.02.048. This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. © 2020 Elsevier Inc. All rights reserved.
1
Bladder Endometriosis in Pregnancy
2 3
Harrison Banner, MD, MSc
4
Ally Murji, MD, MPH
5
Mount Sinai Health System, Toronto, Ontario CANADA
6 7
The authors report no conflict of interest.
8 9 10 11
Corresponding Author
12
Harrison Banner, Mount Sinai Health System, Toronto, Ontario CANADA
13
[email protected]
14 15
16
A 37-year-old G3P2, with two prior Caesarean sections, was referred with hematuria in
17
pregnancy. The patient endorsed longstanding dysmenorrhea and catamenial hematuria.
18
Transabdominal ultrasound showed an avascular 4.3x1.7x3.2cm mass arising from the posterior
19
bladder wall (Panel A) with papillary projections extending into the bladder (Panel B and Video).
20
The placenta was fundal. Cystoscopy at 10 weeks gestation confirmed an exophytic mass
21
distorting the bladder trigone. Biopsy was consistent with endometriosis. Mass size and
22
appearance remained unchanged on serial ultrasounds.
23
Repeat cystoscopy at Caesarean confirmed the previous findings (Panel C and Video)
24
with no evidence of other pelvic endometriosis. At 6 weeks post-partum, the patient started
25
oral progestin.
26
Endometriosis is more common in women with previous uterine surgery and should be
27
considered in the differential diagnosis of bladder mass in pregnancy. Biopsy is safe and
28
necessary to exclude malignancy. Masses should be followed serially until they can be safely
29
treated postpartum.