Endometriosis - Dysmenorrhoea & Infertility

Symptoms

A 35 year old woman presented with dysmenorrhoea and primary infertility.

Diagnosis

She was an ex-smoker. All investigations were normal.

Procedure

She elected to undergo laparoscopy. This revealed pigmented endometriosis which was excised. There was very minimal disease on both ovaries and this was very carefully diathermied.

Outcome

The pain resolved. She had a successful pregnancy following IVF.

Laparoscopic view of uterus and both ovaries

Pigmented endometriosis in Pouch of Douglas and right Pelvic Side Wall

The endometriosis is excised

Appearance of the Pouch of Douglas after endometriosis has been excised

Pigmented endometriosis on left ovary

Left ovary after very careful diathermy of endometriosis