Laparoscopy - Cyst, Fibroid & Endometriosis

Symptoms

A 32 year old woman presented with infertility. She experienced dysmenorrhoea.

Diagnosis

A Pelvic Ultrasound revealed a 53mm right ovarian dermoid cyst and a 30mm pedunculated fibroid. The other fertility investigations were within the normal range.

Procedure

She proceeded to laparoscopy which revealed Grade IV endometriosis in addition to the fibroid and dermoid cyst. All areas of pathology were laparoscopically treated.

Outcome

She then naturally conceived within 6 months.

The laparoscopic view of the pelvis - the fibroid on the posterior wall of the uterus.

The right ovarian dermoid cyst. There is evidence of endometriosis over the left side wall and the left ovary is adherent.

The dermoid cyst is removed carefully to preserve normal ovarian tissue.

The endometriosis is excised. This extended to the right pelvic side wall, deep utero-sacral ligament and posterior cervix.

The fibroid is removed.

The normal pelvis at the end of the procedure. Two ovaries and the pelvic side walls are seen.