Clinical pitfalls of pain recurrence in endometriosis arising in the posterior vaginal fornix

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

This case study describes a patient whose posterior vaginal fornix endometriosis was overlooked, leading to persistent pain despite GnRHa therapy and abdominal surgery, and whose symptoms resolved after trans-vaginal resection.

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Abstract

Endometriotic nodules in the lower genital tract often cause dysmenorrhea and dyspareunia. We report here a case of posterior vaginal fornix endometriosis that was overlooked for several years. We performed a trans-vaginal resection after the associated pain was not relieved by repetitive gonadotropin-releasing hormone agonist (GnRHa) therapy or abdominal surgery. After the resection, the patient's symptoms disappeared. The patient subsequently conceived and proceeded to a full-term delivery. The pathological diagnosis was 'endometriosis of the vagina.' Immunohistochemical staining revealed that the progesterone receptor-positive cells outnumbered the estrogen receptor-positive cells. We emphasize that the existence of vaginal lesions should be considered in cases in which pain has not improved despite long-term GnRHa administration, or in cases involving dyspareunia. To provide appropriate treatment, attentive evaluation and careful examination of the disease are necessary for a patient with prolonged unsatisfactory progress.

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Condition tags

dysmenorrheadyspareuniaendometriosis

MeSH descriptors

Dyspareunia Endometriosis Vaginal Diseases Adult Danazol Danazol Dysmenorrhea Dysmenorrhea Dysmenorrhea Dyspareunia Dyspareunia Endometriosis Endometriosis Endometriosis Endometriosis Estrogen Antagonists Estrogen Antagonists Female Gonadotropin-Releasing Hormone Gonadotropin-Releasing Hormone

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (10)

Cited by (2)

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europepmc
last seen: 2026-07-03T06:58:25.718087+00:00
openalex
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