Pouch of Douglas Endometriosis - Laparoscopy

Symptoms

A 35 year old woman presented with severe dysmenorrhoea and cyclical rectal pain.

Diagnosis

A pelvic USS was normal. She subsequently had a laparoscopy which revealed pigmented endometriosis in the Pouch of Douglas (near the rectum).

Procedure

This area was excised.

Outcome

The pain resolved.

Laparoscopic view of the Pouch of Douglas (behind the cervix). The endometriosis is seen as a pigmented area.

The nodule of endometriosis is being dissected out.

The nodule of endometriosis is being dissected out. Meticulous care is taken because the lesion is very close to the rectum.

The nodule of endometriosis has been excised. The view of the pelvis at the end of the procedure.