Endometriosis and adenomyosis in a Mullerian agenesis patient: A delayed presentation

Mullerian duct anomalies are developmental anomalies resulting from failure in organogenesis, fusion, or the reabsorption of the paired Mullerian ducts. Endometriosis and Mullerian anomalies have a high coincidence rate. Obstructive uterine malformations with functioning endometrium have higher chances of co-incident endometriosis. Continuous bleeding into functional uterine remnants can lead to the formation of hematometra, endometriosis, and adenomyosis. We report a case of primary amenorrhea who reported 18 years after vaginoplasty with pain abdomen due to the presence of endometriosis in bilateral ovaries and adenomyosis in the rudimentary uterine horn.