Laparoscopic surgery for an infertile woman with a peritoneal inclusion cyst surrounding the entire ovary with contralateral hydrosalpinx: a case report

Akira Nakabayashi, Kenji Sato, Hirotaka Masuda, Yu Sato, Yohei Akiba, Hiroshi Senba, Sayaka Uchida, Kou Sueoka, Mamoru Tanaka
In: JAPANESE JOURNAL OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY · 2017 · vol. 33(1) , pp. 107–111 · doi:10.5180/jsgoe.33.107 · W2623297257
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⚙ AI-generated summary by claude@2026-06, 2026-06-12 ⓘ

Laparoscopic surgery successfully treated an infertile woman's peritoneal inclusion cyst encompassing the entire ovary and contralateral hydrosalpinx, presumed to be caused by endometriosis and chlamydia.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-12 · read from full text ⓘ

This case report describes laparoscopic surgery in a 35-year-old infertile woman with a peritoneal inclusion cyst (PIC) surrounding the entire left ovary and a contralateral hydrosalpinx, thought to be caused by endometriosis and a history of untreated chlamydia infection. Using ultrasound and MRI for diagnosis, laparoscopy found endometriosis-related adhesions and right-tubal hydrosalpinx, and the operative steps included complete resection of the PIC cyst wall, adhesiolysis, removal of endometrial lesions, and salpingostomy of the right fimbria. The authors conclude that laparoscopic PIC removal can address PIC’s negative influence on oocyte retrieval and limit cyst enlargement during pregnancy, while emphasizing that extensive pelvic adhesions can make surgery technically difficult. This paper is centrally about endometriosis — it reports PIC and adhesions attributed to endometriosis discovered and treated during laparoscopic management in an infertile patient.

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Abstract

Objective: We report laparoscopic surgery for an infertile woman with a peritoneal inclusion cyst (PIC) surrounding the entire ovary and a hydrosalpinx of the opposite side, which were considered to have been caused by endometriosis and chlamydia infection.
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Objective

We report laparoscopic surgery for an infertile woman with a peritoneal inclusion cyst (PIC) surrounding the entire ovary and a hydrosalpinx of the opposite side, which were considered to have been caused by endometriosis and chlamydia infection. Patient: The patient had a history of untreated chlamydia infection. Ultrasound and magnetic resonance imaging revealed a PIC and a hydrosalpinx. In order to improve chances of conception, the patient underwent laparoscopic surgery. The PIC was formed with a thin layer of tissue lining the left tube and the broad ligament; the left ovary was completely surrounded by the PIC. At the time of surgery, adhesion by endometriosis and a hydrosalpinx of the right tube were observed. The surgery proceeded in the following stages: 1. complete resection of the cyst wall; 2. adhesiolysis between the uterus and the rectum, and also between the right ovary and the broad ligament; 3. removal of endometrial lesions; 4. salpingostomy of the right fimbria.

Conclusion

Surgery for PIC removal to prevent its negative influence on oocyte retrieval and its enlargement during pregnancy is effective for infertile women. Laparoscopic surgery should be the first choice in terms of its minimal invasiveness and curativeness. However, superior laparoscopic surgical skill is required because many PIC cases have extensive adhesion in the pelvis, such as in our case, which makes surgery difficult. As PIC with infertility is expected to also present with a tubal disorder, patients need to be well informed of the treatment plan in advance. © 2017 日本産科婦人科内視鏡学会

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Condition tags

endometriosis

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last seen: 2026-06-04T00:00:01.174412+00:00
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