Authors: Adel Shervin

This 31 years old G:O P:O , married for 12 years, with h/o infertility for past 10 yeas was referred by urologist because of: Sever pelvic pain & dysparunia, painful urination with urgency & frequency and ureteral Endometriosis. Her past history is pertinent for Laparoscopic surgery for treatment of endometriosis 6 years ago, evidently was complicated with post of infections and 6 days of hospitalization with antibiotic treatment, patient had numerous coursed of medical treatment for Endometriosis and ovulation induction for infertility, one IVF 3 years ago again was complicated with PID, treated with 5 days of hospitalization and treatment, recently was hospitalized because of acute Pyelonephritis by Urologist, IVP revealed Bilateral hydroureteronephrosis, Spiral CT scan indicated Bilateral complex adnexal mass and hydroureteronephrosis on both sides, patient denied bowel symptoms and was persistent to have her uterus removed because of crippling pelvic pain & dysparunia.

Her laparoscopic surgery took about 4 hours with minimal blood loss, PO period was uneventful, JJ catheters was removed 6 weeks latter, pain relief by patient description was excellent. pathology report was notable for Iliac lymph node endometriosis on (R) side, all other removed tissue revealed endometriosis and chronic inflammation.