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Case 73 - A 32-Year-Old P0 Woman with Persistent Pain after LAVH/BSO for Endometriosis
- By James N. Casey
Edited by Todd R. Jenkins, University of Alabama, Birmingham, Lisa Keder, Abimola Famuyide, Kimberly S. Gecsi, David Chelmow
Book:

Surgical Gynecology

Published online:

19 November 2021

Print publication:

02 December 2021, pp 222-224
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Summary

A 32-year-old para 0 presents with persistent pain after laparoscopic assisted vaginal hysterectomy/bilateral salpingo-oophorectomy (LAVH/BSO) for endometriosis. Her surgery was notable for bilateral endometriomas with scarring of the ovaries to each respective ovarian fossa and adhesions of the rectosigmoid colon to the left ovary. She had an uneventful recovery from surgery and was started on estrogen-only therapy for skeletal and cardiovascular protection. Three months following surgery, she reports the onset of an intense intermittent left lower quadrant pain. This began cyclically though it has progressed to pain for at least two weeks of each month. She has no past medical history. Her past surgical history is significant for three laparoscopic endometriosis surgeries, LAVH/BSO. She is taking estradiol (Estrace) 1 mg PO daily. She has no allegies.