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

Tachibana M, Masahito Tachibana, Takashi Murakami, Murakami T, Hiroki Utsunomiya, Utsunomiya H, Terada Y, Yukihiro Terada, Nobuo Yaegashi, Yaegashi N, Kunihiro Okamura, Okamura K
Journal of Obstetrics and Gynaecology Research · 2007 · vol. 33(2) , pp. 207–210 · doi:10.1111/j.1447-0756.2007.00503.x · PMID:17441898 · W2124206595
Case report OA: closed CC0 ⤵ 2 in-corpus citations
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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 Adult Danazol Danazol Danazol Dysmenorrhea Dysmenorrhea Dysmenorrhea Dysmenorrhea Dyspareunia Dyspareunia Dyspareunia Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis

Citation neighborhood (2-hop)

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. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (10)

Cited by (2)

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License: CC0 · commercial use OK