Persistence of endometriosis after correction of an obstructed reproductive tract anomaly

BACKGROUND: Endometriosis is commonly found in adolescents with an obstructed reproductive tract and has been reported to always regress after correction. This study highlights 5 patients who had persistent pain and a diagnosis of endometriosis following correction of their anomaly. CASES: The cases include patients with agenesis of the lower vagina or an obstructed hemivagina. All had recurrence of pain 6 months to 5 years after their corrective surgery. Laparoscopy revealed Stage I, II, and IV endometriosis. SUMMARY AND CONCLUSIONS: This case series reveals that endometriosis does not always resolve following repair of an obstructive anomaly. This may result from prior/ongoing peritoneal seeding or other factors. Given possible disease progression and potential adverse effect on fertility, it important to consider laparoscopy and medical therapy if these patients have persistent pain.