Pelvic Pain - Endometriosis
Symptoms
A 27-year-old woman presented with severe dysmenorrhoea and pain with intercourse (dyspareunia). She also complained of bowel-related pain during menstruation.
Diagnosis
Laparoscopy revealed significant endometriosis behind the uterus (Pouch of Douglas) which extended right through to the vagina.
Outcome
The patient made an excellent recovery and the pain completely resolved.
Procedure
The endometriosis was excised and this involved dissection of the pelvic sidewall and extended down to the vagina. The vaginal incision was closed laparoscopically. An IUCD was inserted into the uterus at the end of the operation.
The puckered area on the left is the endometriosis
The endometriosis extended through to the vagina and a small area of the vagina is removed. This area is closed laparoscopically
Showing a normal pelvis at the end. The right ovary is also see
Dissection of pelvic side wall to remove all endometriosis
At the end of the operation. This shows the area behind the uterus where the endometriosis has been completely removed. This is a close-up picture