Dysmenorrhoea - Endometriosis
A 30 year old woman presented with dysmenorrhoea.
She denied dyspareunia and pain with bowel motions. Laparoscopy revealed the rectum was adherent to the posterior cervix with endometriosis.
Excision of endometriosis involved a thorough dissection to identify the ureters and the limits of the rectum. The endometriosis was full thickness through the rectum and the involved part was excised. The wall was closed in two layers.
She made an excellent recovery and the pain resolved.
Rectal endometriosis is pigmented pink. The bowel is adherent to posterior cervix
The rectum has been liberated and affected area of the wall excised.
The area on the left demonstrates closure of the rectum following excision of endometriosis.