Case endometriosis

Electively admitted for laparotomy cystectomy for bilateral endometriosis

Patient is married since 7 years ago. After 7 years practice of regular unprotected sexual intercourse (about 2-3 times per week), patient was still unable to get pregnant. Patient undergone intrauterine insemination (IUI) once in 2010 in Hospital Kuala Terengganu but failed.

Patient started taking medication from homeopathy since October 2011 for 3 months duration. During the period of time she noted there was a swelling in her abdomen which progressively increased in size from the initial size of egg. The swelling was painless, round in shape and occur at suprapubic area with firm consistency and non pulsatile. Otherwise no constipation, diarrhea, abdominal distension, abdominal pain, hematuria, dysuria, passing sandy urine, loin pain, fever, unable to pass urine.

Patient also noted that the period became longer and she bled more than usual. Previously she only had 7-9 days period but currently it went up to 11 days. The peak was also longer than usual ;from 3 days peak to 5 days. During peak she usually bled 5 pads fully soaked without clots and currently she used up to 7 pads fully soaked without blood clot.

Besides that she also experienced cramping abdominal pain during menses lasted for 1 day. She claimed that prior to this she also had the similar episodes of abdominal pain during menstrual period since menarche but it increased in severity after she got married.

Otherwise there was no history of intermenstrual bleeding, pervaginal bleed, deep dyspareunia, postcoital bleed.

She went to private clinic nearby her house and the scan was done. She was told by the dr that she had cyst and was referred to HUSM.