Difficult identification of tissue planes in adenomyomectomy following GnRH agonist therapy leading to endometrial damage during laparoscopic adenomyomectomy requiring reconstruction of endometrial cavity: A picture story

Adenomyosis and fibroids are two entities which co-exist and are sometimes difficult to differentiate by imaging. GnRH treatment can obscure the tissue planes making myomectomy or adenomyomectomy technically challenging. We report a case of difficult laparoscopic adenomyomectomy following GnRH therapy leading to significant loss of endometrium, which was successfully reconstructed using an inflated foley catheter balloon as a support.