- Urinary symptoms like pain, urgency, and frequency that get worse with your period may be bladder endometriosis.
- The condition is often mistaken for recurrent UTIs or interstitial cystitis.
- A specialist diagnosis using MRI or cystoscopy is essential.
- Treatment involves hormonal management or specialist surgery to remove the tissue.
What is Bladder Endometriosis?
Bladder endometriosis is a condition where endometrial-like tissue grows on the surface of or inside the bladder wall. This tissue behaves like the uterine lining, thickening and bleeding in response to monthly hormonal changes.
This process triggers inflammation, pain, and a host of urinary symptoms. It's less common than endometriosis in the pelvis but is an important diagnosis to consider for women with persistent, cyclical bladder issues.
Recognising the Symptoms
The classic sign of bladder endometriosis is urinary symptoms that are worse during your period. This can include feeling a frequent or urgent need to urinate, pain or burning when you urinate, and a sense of pressure or pain in the bladder area.
Some women may also notice blood in their urine (haematuria), specifically during menstruation. These symptoms can be easily confused with a urinary tract infection (UTI) or interstitial cystitis, but the cyclical nature is the key differentiator.
How We Diagnose and Treat Bladder Endometriosis
Diagnosis involves a careful review of your symptoms, particularly their relationship to your menstrual cycle. While a urine test can rule out a UTI, specialised imaging like an MRI is often needed to see the endometriosis nodules on the bladder.
In some cases, a cystoscopy (a camera examination of the bladder) is performed, which can directly visualise the lesions. Getting this diagnosis can be a long process on the NHS, and you should be seen by a gynaecologist with a special interest in endometriosis, sometimes jointly with a urologist.
Treatment ranges from hormonal therapies to suppress your cycle and manage symptoms, to specialist laparoscopic surgery to excise the tissue. Surgical removal, which can sometimes involve removing a small part of the bladder (partial cystectomy), offers the most definitive solution.
Frequently asked questions
Can bladder endometriosis be dangerous?
While distressing, bladder endometriosis is rarely dangerous. In very rare cases, if the nodules block the ureters (the tubes from the kidneys to the bladder), it can cause kidney issues. This is why a proper diagnosis and management plan are so important.
Will I need a urinary catheter after surgery?
If you have surgery to shave endometriosis from the bladder surface, you might not need a catheter. If a piece of the bladder is removed (partial cystectomy), you will have a catheter for 7-14 days to allow the bladder to heal properly.
I've been told I have interstitial cystitis. Could it be endometriosis?
The conditions can feel very similar. However, if your pain and urinary frequency are significantly worse during or just before your period, it is worth pursuing a specialist opinion to investigate for endometriosis, as treatments differ.
Is blood in my urine always a sign of bladder endometriosis?
No, you must never assume this. While cyclical blood in the urine is a classic sign, any blood in the urine needs to be properly investigated by a doctor to rule out other causes, such as infections or other bladder problems.
Could a doctor-led plan help you?
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