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Müllerianosis of the urinary bladder: a rare and problematic bladder tumour. Müllerianosis of the bladder is an extremely rare and highly symptomatic bladder tumour comprising of at least two types of Müllerian derived tissues. We present the case of a 59-year-old woman presenting with painful macroscopic haematuria associated with urgency, frequency and incontinence. She is a nulliparous postmenopausal woman without malignancy risk factors or previous abdominal surgery. Initially identified on ultrasound scan, she was taken for transurethral resection of bladder tumour (TURBT). Histology confirms the diagnosis. Repeat TURBT was required for non-resolution of symptoms. Despite a thorough resection, symptoms recurred within months necessitating partial cystectomy. Although a 'benign' lesion, this lesion proved a difficult condition to treat requiring partial cystectomy.