When endometriosis returns: managing vault involvement after hysterectomy: a case report

Anuvi Sinha; Tushar L. Rahane; Niteen Ghorpade

doi:10.18203/2320-1770.ijrcog20251998

When endometriosis returns: managing vault involvement after hysterectomy: a case report

Anuvi Sinha, Tushar L. Rahane, Niteen Ghorpade

In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2025 · vol. 14(7) , pp. 2391–2394 · doi:10.18203/2320-1770.ijrcog20251998 · W4411679901

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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This case report describes a 41-year-old patient with post-hysterectomy vault endometriosis successfully treated with laparoscopic excision of an endometriotic nodule and bladder serosal shaving.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-08 ⓘ

This case report describes a 41-year-old woman with irregular vaginal bleeding developing 7–8 years after a total laparoscopic hysterectomy, with a growth at the vaginal vault evaluated by biopsy and found to be suggestive of endometriosis. MRI was used to assess and rule out involvement of the bladder and rectum, followed by elective laparoscopic excision of an endometriotic nodule with bladder serosal shaving. The patient’s postoperative symptoms were relieved. As a single-patient report, the findings are limited to this clinical scenario. This paper is centrally about endometriosis — it reports management of post-hysterectomy vault endometriosis.

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Abstract

Vault 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.