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