34 – Laparoscopic Management of Gynecologic Benign Bladder Tumors-Leiomyoma and Endometriosis

Leiomyoma and endometriosis are common benign uterine diseases. We will present two rare cases of leiomyoma and endometriosis of the bladder. Case 1 underwent TLH for sub mucosal myoma (by gynecologists) and transurethral resection of bladder leiomyoma (by urologists) in one surgical session. The bladder was perforated during the later stage. Gynecologists were called for laparoscopic bladder repair. We dilated the perforation site and removed the bladder leiomyoma. Then the myoma-bed and laceration were reapproximated laparoscopically. Case 2 had extensive bladder endometriosis involving the right ureteral orifice. Full-layer discoid resection was performed and the defect was reapproximated in two layers. The involved lower ureter was resected and the urinary tract was reconstructed by ureteroneocystostomy. Recovery of both cases was quick with minimal blood loss and minimal operative wounds. Understanding of pelvic anatomy and laparoscopic suturing allows for the treatment of rare disorders as well as extensive organ repair.