Bladder Endometriosis: Symptoms, Diagnosis, And Treatment

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Endometriosis and bladder pain

A woman with bladder endometriosis posing in a chair. — Guille Faingold/Stocksy

During regular menstruation, endometrial tissue inside the uterus thickens and exits the body through the vagina.

In endometriosis, similar tissue grows outside of the uterus and cannot exit the body. Symptoms of endometriosis include painful menstrual cramps, heavy periods, chronic pelvic pain, and more.

Sometimes, endometriosis tissue can grow in and on the bladder. Doctors call this bladder endometriosis. It is rare, but when it happens, it can be painful.

Bladder endometriosis causes inflammation and pain in the bladder.

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Is bladder endometriosis common?

Endometriosis is common, affecting around 10% of females of reproductive age.

However, bladder endometriosis is rare. Approximately 1% of people with endometriosis will have tissue growth in their urinary tract.

Additionally, after the gastrointestinal tract, the urinary system is the second most common site of endometriosis outside of the pelvic region.

Endometriosis is more likely to affect the bladder than any other organ in the urinary system, with 85% of people with urinary tract endometriosis occurring in the bladder.

Symptoms

Researchers estimate that around 50% of people with endometriosis in their urinary tract — which includes the bladder — display no symptoms.

For others, the symptoms of bladder endometriosis can include:

needing to urinate urgently
frequent urination
pain when the bladder is full
burning or painful urination
blood in the urine
pelvic pain
lower back pain on one side

When endometriosis develops in other parts of the pelvis, symptoms may include:

painful periods
pain during sex
bleeding between periods
heavy periods
feeling extremely tired
nausea
diarrhea

Bladder endometriosis vs. interstitial cystitis

Interstitial cystitis (IC) has similar symptoms to bladder endometriosis.

The symptoms include:

pelvic pain that lasts 6 months or more
needing to urinate frequently and urgently
pain during sex
needing to urinate at night
pain in the bladder
symptoms affected by the menstrual cycle

Doctors think that a damaged bladder lining may cause interstitial cystitis.

Bladder endometriosis vs. other bladder pain

Other possible causes of bladder pain include bladder infection, a type of urinary tract infection, and bladder cancer.

Anyone who has bladder pressure or pain that does not go away should speak with a doctor.

Possible causes of bladder endometriosis

Researchers do not know exactly what causes endometriosis.

However, some things make developing it more likely. Doctors call these risk factors.

They include:

having a mother, sister, or daughter with endometriosis
having periods start before turning 11 years old
having short monthly menstruation cycles of less than 27 days
having heavy periods that last more than 7 days

Bladder endometriosis occurs when the endometrial tissue resembling that of the lining of the uterus grows in the bladder. Researchers are not exactly sure how this happens.

However, some suggest it is due to an abnormality in the peritoneum — the thin membrane that protects the abdominal organs — that allows the endometrial cells to enter other organs.

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Diagnosis

To diagnose bladder endometriosis, a doctor will first perform a physical pelvic exam.

The next step is usually checking for blood in the person’s urine.

After this, the doctor may perform other tests, such as:

Ultrasound: An ultrasound scan uses high-frequency sound waves to create pictures of the inside of the body. A doctor cannot see endometriosis tissue with this method, but they can use it to check for cysts and rule out other problems.
MRI: An MRI scan uses magnets and radio waves to produce detailed images of the inside of the body. A doctor can then see if any abnormal tissue is growing, where it is, and how much there is.
Cystoscopy: During a cystoscopy, the doctor inserts a small tool with a camera attached to it through the urethra. This allows them to look at the bladder lining to see whether any endometriosis tissue is growing there.

Learn more
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Stages of endometriosis

Doctors use stages to define how much abnormal tissue is present and how deeply it has grown into the person’s organs.

There are four stages:

Stage 1 (minimal): A person with stage 1 endometriosis only has small amounts of tissue growth, and it is only present on the surface or around the organs.
Stage 2 (mild): A person with stage 2 endometriosis has more extensive tissue growths, but they are still on the surface of the organs rather than inside of them.
Stage 3 (moderate): A person with stage 3 endometriosis has more widespread tissue growth, which has begun to grow inside the pelvic organs.
Stage 4 (severe): A person with stage 4 endometriosis has lots of endometrial-like tissue, which is growing inside several of the pelvic organs.

Treatment

There is no cure for endometriosis. However, people can treat some of their symptoms, including pain.

The National Institutes of Health warn that not all treatments work well for everyone. Endometriosis may also return with time.

The three main types of treatment for endometriosis pain are:

Hormone therapy: Hormonal treatments, such as the contraceptive pill and hormonal IUD, may stop periods. They can slow the growth of abnormal tissue, but it does not make existing growths go away.
Pain medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen may help people with mild symptoms.
Surgical treatments: Sometimes, doctors may recommend surgery to remove some or all of the abnormal tissue. It can help with the symptoms, but it doesn’t stop the tissue from growing back.

Doctors use two types of surgery for bladder endometriosis. These include transurethral surgery, which involves inserting a thin tool with a blade on the end into the bladder to remove endometrial tissue, and a partial cystectomy, which involves removing an affected part of the bladder.

For bladder endometriosis, a person may find that making changes to their diet helps their urinary symptoms. For example, eliminating alcohol and caffeinated drinks from their diet may reduce bladder irritation and pain.

Learn more
Learn more about endometriosis treatments and management.
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What happens if someone with bladder endometriosis does not receive treatment?

Endometriosis is a progressive disease. That means it will get worse over time.

Untreated, the condition can significantly impact a person’s quality of life. The pain can be severe, which can stop people from enjoying their lives or going about their everyday activities.

Dealing with chronic pain can cause or worsen mental health problems, such as depression and anxiety.

Sometimes, untreated endometriosis can spread to the ureters, the tubes that link the bladder to the kidneys. While very rare, when it happens, it can damage the kidneys.

Fertility

Bladder endometriosis does not cause infertility.

However, many people with abnormal tissue in their bladder will also have it in their ovaries or other parts of their reproductive system. These forms of endometriosis can cause infertility.

However, treatments for endometriosis-related infertility do exist. Doctors may recommend surgery to remove the abnormal tissue and in vitro fertilization (IVF).

Learn more about endometriosis and infertility.

Outlook

There is no cure for endometriosis. However, many people use pain medication and lifestyle changes to manage the symptoms.

Often, removing the endometrial tissue surgically is the most effective treatment. However, endometriosis tends to come back, meaning a person may need multiple operations.

A person may find that making lifestyle changes, such as changing their diet and exercising regularly, may help alleviate some of their endometriosis symptoms.

For bladder endometriosis specifically, a person may find that avoiding alcohol and caffeinated drinks helps relieve their bladder pain and irritation.

Opting for hormone therapy may bring some relief from symptoms related to the menstrual cycle. If a person wishes to become pregnant, they should talk with a doctor about which medication is best for them.

There are treatments available for infertility related to endometriosis, such as IVF.

Frequently asked questions

This section answers some frequently asked questions about bladder endometriosis:

How long can you live with endometriosis?

Endometriosis is not a life-limiting condition, meaning people do not die from it. However, there is no cure, so it is a lifelong condition.

Does bladder endometriosis show up on ultrasound?

The endometrial tissue itself may not show up on an ultrasound scan.

However, doctors can sometimes tell if a person has bladder endometriosis by looking at abnormalities in their bladder through an ultrasound image.

For example, they can see the thickening of the bladder walls and any cysts or masses that are present.

Summary

Endometriosis happens when tissue similar to the tissue inside of the uterus grows outside of the uterus.

When the tissue grows on or in the bladder, doctors call it bladder endometriosis. It can cause bladder pain.

Urinary tract endometriosis, which includes the bladder, happens in about 1% of people with endometriosis. There is no cure for the condition, though treatments are available for some of the symptoms, including pain.

Other causes of bladder pain include interstitial cystitis and urinary tract infections.

Endometriosis
Urology / Nephrology
Women's Health / Gynecology

How we reviewed this article:

SourcesMedical News Today has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

About endometriosis. (2020).https://www.nichd.nih.gov/health/topics/endometri/conditioninfo
Bladder infection (urinary tract infection—UTI) in adults. (2017).https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-infection-uti-in-adults/all-content
Chan, C., et al. (2017). Bladder endometriosis: A case report.https://journals.lww.com/ultrasound-quarterly/Citation/2017/03000/Bladder_Endometriosis__A_Case_Report.24.aspx
Endometriosis. (2021).https://www.womenshealth.gov/a-z-topics/endometriosis
Endometriosis [Fact sheet]. (2021).https://www.who.int/news-room/fact-sheets/detail/endometriosis
Endometriosis stages: Understanding the different stages of endometriosis. (n.d.).https://www.endofound.org/stages-of-endometriosis
Key statistics for bladder cancer. (2023).https://www.cancer.org/cancer/bladder-cancer/about/key-statistics.html
Leonardi, M., et al. (2020). Endometriosis and the urinary tract: From diagnosis to surgical treatment.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7650710/
Lim, Y., et al. (2022). Interstitial cystitis.https://www.ncbi.nlm.nih.gov/books/NBK570588/
Parasar, P., et al. (2017). Endometriosis: Epidemiology, diagnosis and clinical management.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5737931/
Saccardi, C., et al. (2017). Bladder endometriosis: A summary of current evidence [Abstract].https://pubmed.ncbi.nlm.nih.gov/28381080/
Tsamantioti, E. S., et al. (2022). Endometriosis.https://www.ncbi.nlm.nih.gov/books/NBK567777/
What is interstitial cystitis (IC)/bladder pain syndrome? (n.d.).https://www.urologyhealth.org/urology-a-z/i/interstitial-cystitis
Xu, M. C., et al. (2020). Conservative management of bladder endometriosis with acute renal failure.https://www.sciencedirect.com/science/article/pii/S2214442020301510
Yildirim, E. Z. (2016). Endometriosis of the bladder [Abstract].https://jurolsurgery.org/archives/archive-detail/article-preview/endometriosis-of-the-bladder/11953

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Medically reviewed by Jenneh Rishe, RN — Written by Bethany Cadman and Amanda Barrell — Updated on February 15, 2023

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A note about sex and gender

Endometriosis and bladder pain

Is bladder endometriosis common?

Symptoms

Bladder endometriosis vs. interstitial cystitis

Bladder endometriosis vs. other bladder pain

Possible causes of bladder endometriosis

Diagnosis

Stages of endometriosis

Treatment

What happens if someone with bladder endometriosis does not receive treatment?

Fertility

Outlook

Frequently asked questions

How long can you live with endometriosis?

Does bladder endometriosis show up on ultrasound?

Summary

How we reviewed this article:

Latest news

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