Laparoscopic approach to an endometriotic vault fistula causing posthysterectomy "menstruation"

Journal of Minimally Invasive Gynecology
Reeba OliverDavid Khoo

Abstract

Endometriosis is a commonly prevalent disease but can include rare complaints posing a challenge to surgical treatment. We describe an unreported cause of menstruation after hysterectomy, which was revealed as an endometriotic tubo-ovarian mass that fistulated into the vaginal vault. A 37-year-old woman experienced monthly vaginal bleeding after hysterectomy. At laparoscopy a tubo-ovarian endometriotic mass was revealed with a fistula into the vaginal vault. The mass was adherent to the left ureter and the sigmoid colon. Laparoscopic excision of the mass and fistula after ureterolysis and bowel dissection was performed. This case describes an unreported cause of posthysterectomy menstruation. The management outlines the optimal surgical management of laparoscopic techniques combined with vaginal access to achieve complete excision with minimal patient morbidity.

References

Aug 1, 1994·The Journal of the American Association of Gynecologic Laparoscopists·F R NezhatC Nezhat
Oct 30, 2004·Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology·P J LoweG T Kovacs
Nov 19, 2004·International Urogynecology Journal and Pelvic Floor Dysfunction·Alessandro AntonelliSergio Cosciani Cunico

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Citations

Mar 25, 2009·Archives of Gynecology and Obstetrics·Yavuz AydinMelahat Donmez
Jul 9, 2009·Archives of Gynecology and Obstetrics·Basil Trench LyngdohRajni Bansal
Jul 8, 2010·Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology·A Jain, B Kumar
Oct 4, 2016·Journal of Minimally Invasive Gynecology·Sandip Datta Roy, Mandeep Bhandal

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