Hematometra following laparoscopic resection of retrocervical and rectovaginal endometriosis

Abstract

Objective: To report a case of hematometra following laparoscopic resection of rectovaginal endometriosis extending to the cervix.

Design: Case report.

Setting: University hospital.

Patient(s): A 31-year-old woman with endometriosis and infertility.

Intervention(s): Combined laparoscopic and vaginal surgery.

Result(s): The cervix had retracted into the vaginal scar after surgery, preventing the escape of menstrual blood. The hematometra was drained, and the cervix was repositioned into the vagina with use of a combined vaginal and laparoscopic approach.

Conclusion(s): Retraction of the cervix into the cul-de-sac can occur as a complication of excision of rectovaginal nodules that extend onto the posterior surface of the cervix. Excision of the posterior cervix should avoid deep excision of the posterior lip and should be limited only to the ectocervical margin to avoid such complications.