Endometriosis Caused Severe Dysmenorrhoea

Dr Jenny Cook  |  Gynaecologist & Advanced Laparoscopic Surgeon

Endometriosis Recurrence - Endometrioma Drainage

Symptoms

A 35 year old woman presented with severe dysmenorrhoea. She had a laparoscopy with drainage of a large endometrioma about 10 years prior to this presentation.

Diagnosis

Laparoscopy revealed Stage IV endometriosis.

Procedure

Drainage of an endometrioma is known to be associated with a high rate of endometriosis recurrence.

Outcome

All visible endometriosis was treated and the pain resolved.

The left ovary is adherent to the left side wall.
The left ovary is adherent to the left side wall.
Very inflamed endometriosis and adhesions around the left tube and ovary are noted
Very inflamed endometriosis and adhesions around the left tube and ovary are noted
Dividing the adhesions and mobilising the left ovary and tube.
Dividing the adhesions and mobilising the left ovary and tube.
A 30mm right ovarian endometrioma which is adherent to the right side wall, posterior cervix and right utero-sacral ligament
A 30mm right ovarian endometrioma which is adherent to the right side wall, posterior cervix and right utero-sacral ligament
The right ovary has been mobilised and the endometrioma wall excised. The right ureter has been dissected out and endometriosis on right side wall excised
The right ovary has been mobilised and the endometrioma wall excised. The right ureter has been dissected out and endometriosis on right side wall excised
The left ovary is mobilised. A small endometrioma is noted and excised. The left ureter is dissected out and endometriosis on left side wall excised
The left ovary is mobilised. A small endometrioma is noted and excised. The left ureter is dissected out and endometriosis on left side wall excised
The rectum has been dissected from posterior cervix by sharp dissection. Endometriosis over the surface of the rectum and para-rectal fossae has been excised.
The rectum has been dissected from posterior cervix by sharp dissection. Endometriosis over the surface of the rectum and para-rectal fossae has been excised.
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