Pelvic Pain During Mensturation

Dr Jenny Cook  |  Gynaecologist & Advanced Laparoscopic Surgeon

Ovarian Endometrioma - Mirena

Symptoms

A 31 year old woman presented with right sided pelvic pain during menstruation.

Diagnosis

A pelvic ultrasound revealed large bilateral ovarian cysts. Laparoscopy revealed bilateral ovarian endometrioma (kissing ovaries).

Procedure

All endometriosis was excised and a Mirena used post operatively to minimise the risk of endometriosis recurrence.

Outcome

The pain was effectively treated.

The ovarian endometrioma is 9cm and the left ovarian endometrioma is 5cm.
The ovarian endometrioma is 9cm and the left ovarian endometrioma is 5cm. Both are adherent to each other and their respective pelvic side walls. There is a loop of bowel seen which is also adherent to both ovaries.
The bowel has been mobilised. The right ovary is mobilised and the endometrioma wall is stripped. The same procedure is performed on the left ovary.
The bowel has been mobilised. The right ovary is mobilised and the endometrioma wall is stripped. The same procedure is performed on the left ovary.
The endometrioma wall seen next to the uterus.
The endometrioma wall seen next to the uterus.
Both ureters have been dissected out and endometriosis excised from both side walls.
Both ureters have been dissected out and endometriosis excised from both side walls. This is a view of the normal pelvis at the end of the operation. Two normal and mobile ovaries are seen
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