Endometriosis Research Today is a free monthly online journal that collates and summarizes the latest research about Endometriosis, including details on causes, treatment, symptoms, infertility.

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

Tachibana M, Murakami T, Utsunomiya H, Terada Y, Yaegashi N, Okamura K

Department of Obstetrics and Gynecology, Tohoku University School of Medicine, Sendai, Japan. masahito@mail.tains.tohoku.ac.jp

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.

Published 19 April 2007 in J Obstet Gynaecol Res, 33(2): 207-10.
Full-text of this article is available online (may require subscription).

© 2004-2008 Endometriosis Research Today. All Rights Reserved.