Polycystic Ovarian Syndrome - Endometriosis

SYMPTOMS

A 34 year old woman presented with severe dysmenorrhoea and bowel related pain during menstruation.

DIAGNOSIS

She had polycystic ovarian syndrome. She had been attempting to fall pregnant for 12 months. A pelvic ultrasound revealed a 5cm endometrioma of the left ovary.

PROCEDURE

Laparoscopy revealed significant endometriosis. The bowel was adherent to the left ovary. There was a 5cm endometrioma. The right ovary was adherent to the right side wall. The procedure involved a full pelvic dissection to divide adhesions, liberate the ovaries and remove underlying endometriosis. The left endometrioma was drained and stripped.

OUTCOME

She then attempted spontaneous conception for months. She ultimately went through IVF and conceived twins.

The view of the pelvis at laparoscopy showing extensive endometriosis. There is a 5cm left ovarian endometrioma.

The right ovary is liberated from the pelvic side wall. The right ureter has been dissected out.

The left endometrioma is drained and stripped away.
 

The normal pelvis at the end of the procedure. The uterus is now visible. Both ovaries are mobile and underlying endometriosis has been removed.