{"paper_id":"b9f3c26e-a88e-40e5-a4fd-6802b22bbac1","body_text":"When endometriosis returns: managing vault involvement after hysterectomy: a case report\nDOI:\nhttps://doi.org/10.18203/2320-1770.ijrcog20251998Keywords:\nEndometriosis, Vault, Vaginal bleeding, Nodule, Bladder, Bowel, HysterectomyAbstract\nVault endometriosis is a rare but quite challenging condition occurring in post-hysterectomy patients. Minimally invasive surgery remains the gold standard for the diagnosis and management of such cases. We hereby present a case report of a 41-year-old lady who had undergone total laparoscopic hysterectomy 12 years ago and came with irregular vaginal bleeding since 7 to 8 years. She was thoroughly evaluated for the same and underwent biopsy of the growth over the vault, which was suggestive of endometriosis. Magnetic resonance imaging (MRI) was done to rule out involvement of the bladder and rectum. She underwent elective laparoscopic excision of an endometriotic nodule over the vault and bladder serosal shaving. Postoperatively patient was relieved of her signs and symptoms.\nMetrics\nReferences\nPašalić E, Tambuwala MM, Hromić-Jahjefendić A. Endometriosis: Classification, pathophysiology, and treatment options. Pathol Res Pract. 2023;251:154847. DOI: https://doi.org/10.1016/j.prp.2023.154847\nLimbachiya D, Tiwari R, Kumari R. Vault Endometriosis: Detailed Step-by-Step Laparoscopic Surgical Management Technique. JSLS. 2021;25(4):e2021.00057. DOI: https://doi.org/10.4293/JSLS.2021.00057\nChoi CH, Kim JJ, Kim WY, Min KW, Kim DH. A rare case of post-hysterectomy vault site iatrogenic endometriosis. Obstet Gynecol Sci. 2015;58(4):319-22. DOI: https://doi.org/10.5468/ogs.2015.58.4.319\nYoga PP, Jacob OM, Sharmila V, Verma J. A Rare Case of Vaginal Vault Endometriosis in a Post Hysterectomised Woman: A Case Report. Indian J Obstet Gynecol. 2024;12(3):139-42.\nMarkhani LR, Saluja N, Mothe S. Rare Case of Vaginal Bleeding with a Normal Vault following Surgical Menopause. Medico Res Chronicles. 2017;4(1):48-51.\nWorking group of ESGE, ESHRE, and WES; Keckstein J, Becker CM, Canis M, Feki A, Grimbizis GF, Hummelshoj L, et al. Recommendations for the surgical treatment of endometriosis. Part 2: deep endometriosis. Hum Reprod Open. 2020;2020(1):hoaa002. DOI: https://doi.org/10.1093/hropen/hoaa002\nSarkar A, Mahapatra M, Sahu A, Giri SK, Mallick RA. A Case Report of Post Hysterectomy Vault Endometriosis Managed with Laparoscopic Method. Pan Asian J Obs Gyn. 2022;5(1):41-4.","source_license":"CC0","license_restricted":false}