Case of Iatrogenic Endometriosis

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Iatrogenic endometriosis

Iatrogenic endometriosis in parous Slavic woman with history of LASH

Iatrogenic endometriosis is defined as the presence of endometrial glands and stroma out of the uterus because of certain surgical interventions. The rate of iatrogenic endometriosis is after uterine surgeries is 1 to 2%.

This article describes the case of a parous Slavic woman with a history of LASH (a procedure to remove the diseased part of a uterus), 1 year ago because of grade 3 symptomatic apical prolapse. The patient presented to the clinic with a 6-month history of pelvic pain following surgery. The pain aggravated with sexual intercourse and did not alleviate with oral analgesic drug.

Her medical history did not reveal any complaints of urinary incontinence or prolapse. Deep vaginal palpation with a vaginal speculum triggered pain. There were no signs of erosion on the cervix and vaginal wall. Doctors further performed a transvaginal ultrasound which showed a hypoechogenic and hypervascular solid area with irregular contours sized 3 × 2 cm in diameter on the sacral promontory. A transabdominal US was also performed which showed normal kidneys, uterus, and peristalsis.

A flexible cystoscopy with an office-based rectosigmoidoscopy were also advised to rule out reasons for pelvic pain.

There were no other abnormal findings in the bladder and rectosigmoid area. The patient did want to undergo any other diagnostic imaging because of her insurance status.

Doctors discussed the diagnostic possibilities with the patient and scheduled her for a laparoscopy. During surgery, a solid, wine-coloured, hypervascular hemorrhagic lesion was visible macroscopically. The finding was consistent with the diagnosis of endometriosis. There was no sign of invasion of the deeper parts of the organs or pelvic.

The patient was discharged on the first postoperative day. She had an uneventful recovery with no complications. According to the American Society for Reproductive Medicine and category 1, the patient was classified as having stage 1 disease. The patient’s symptoms resoled and no adjuvant treatment was needed for a year after surgery.

References

Iatrogenic endometriosis following apical pelvic organ prolapse surgery: a case report https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-019-2327-x

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Dr. Aiman Shahab is a dentist with a bachelor’s degree from Dow University of Health Sciences. She is an experienced freelance writer with a demonstrated history of working in the health industry. Skilled in general dentistry, she is currently working as an associate dentist at a private dental clinic in Karachi, freelance content writer and as a part time science instructor with Little Medical School. She has also been an ambassador for PDC in the past from the year 2016 – 2018, and her responsibilities included acting as a representative and volunteer for PDC with an intention to make the dental community of Pakistan more connected and to work for benefiting the underprivileged. When she’s not working, you’ll either find her reading or aimlessly walking around for the sake of exploring. Her future plans include getting a master’s degree in maxillofacial and oral surgery, settled in a metropolitan city of North America.

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