Dr Jenny Cook

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Ovarian Endometriosis Causing Severe Pelvic Pain

Ovarian Endometrioma - Endometriosis Surgery

Symptoms

A 45 year old woman presented with severe pelvic pain which required significant amounts of analgaesia. This was affecting her life as she often needed to take days off work. She had never been pregnant and had no plans for a pregnancy.

Diagnosis

A Pelvic ultrasound revealed a left ovarian 55mm endometrioma. Subsequent laparoscopy revealed significant endometriosis.

Procedure

All endometriosis was excised and the pain resolved.

The right ovary is adherent to the uterus and right side wall. There is significant adenomyosis (enlarged, inflamed uterus). The bowel is adherent to the posterior cervix and uterus.

The bowel adhesions are divided carefully by sharp dissection. These cysts are called chocoloate cysts because they contain chocolate -like fluid.

The left ovarian endometrioma is drained and the wall is stripped. The left ovary is mobilised.

The right ovary has been mobilised. All endometriosis from side walls has been excised. This demonstrates the normal pelvis at the end of the operation