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

Masahito Tachibana, Takashi Murakami, Hiroki Utsunomiya, Yukihiro Terada, Nobuo Yaegashi, Kunihiro Okamura

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)207-210
Number of pages4
JournalJournal of Obstetrics and Gynaecology Research
Volume33
Issue number2
DOIs
Publication statusPublished - 2007 Apr 1

Keywords

  • Deeply infiltrating endometriosis
  • Estrogen receptor
  • Progesterone receptor
  • Vaginal endometriosis

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

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