Today, I received copies of all three surgical reports. I think it’s best if they are separated into 3 posts. My first surgery was last May. May 24, 2012. Here’s what it reads (you may need a medical dictionary, I will try to explain what I know);
Pre operative diagnosis:
Chronic pelvic pain, advanced endometriosis, left ovarian chocolate cyst, pelvic adhesions and menometrorrhagia
1. Stage IV deep nodular endometriosis located on the left gutter (pelvic) area, bilateral periureteral spaces (around the ureter), rectosigmoid colon area (part of the large intestine that includes the lower part of the sigmoid and the upper part of the rectum), bilateral (both sides) uterosacral ligament area (a band on each side of the uterus that passes along the lateral wall of the pelvis from the uterine cervix to the sacrum and that serves to support the uterus and hold it in place), right gutter area and anterior cul-de-sac (between the bladder and the uterus) and bladder wall area.
Procedure: Deep excisions
2. Extensive pelvic adhesions, including a completely obliterated Pouch of Douglas (between the rectum and uterus, posterior Cul-de-sac)
Procedure: extensive lysis of adhesions including enterolysis (surgical separation of intestinal adhesions) and bilateral pelvic wall dissection and ureterolysis (freeing the ureter from adhesions). Deeper excision of rectovaginal septum. Reconstruction of the obliterated pouch of Douglas.
3. Large left ovarian chocolate cyst (endometrioma)
Left ovarian cystectomy (removal of the cyst) and left ovarian reconstruction
4. Left severe Hydrosalpinx (a blocked fallopian tube filled with fluid)
Procedure: Chromotubation (testing the fallopain tubes for blockages). Left ovarian Salpingectomy (removal of the left tube).
5. Patent right fallopian tube (was good news)
6. Menometrorrhagia (prolonged or excesssive uterine bleeding) pending pathology report
Procedure: Diagnostic hysteroscopy (endoscopy through the cervix to the uterus) with fractional Dilatation and Curettage (a diagnostic technique in which each section of the uterus is examined and curetted to obtain specimens of the endometrium from all parts).
Repair of incidental cystotomy (the complication of the surgery, my bladder was nicked)
I lost only 150cc/ml’s of blood and woke up with a foley catheter (that I had for a week).
When he got in there he wrote “There was a significant amount of scar tissue and omentum attached to the anterior abdominal wall. This is due to the patient’s previous exploratory laparotomy.”
My uterus was “completely attached to the rectosigmoid colon” and my left ovary and tube were attached to my pelvic sidewall. My left fallopian tube was filled with the chocolate cyst material – blood and was 5x6cm. “there was a very dense band located on the left side round ligament area and part of the anterior cul-de-sac, uterus was deeply attached to the anterior cul-de-sac bladder wall. we were able to do an extensive amount of dissection in this area.” (Yay). “During this dissection, we entered into the bladder by incidental cystotomy.” They cut it by accident.
It goes on to describe the catheter placement and bladder repair, more excision and the recreation of the pouch of Douglas, the right side ovary enterolysis (separation of the parts). A lot of biopsies were taken from everywhere.
He place an Epicel (like a skin graft) over the excisional area and then applied the Intercede (mesh) over the left ovary and rectosigmoid colon area in order to prevent future adhesions.
Here are the pathology results:
Endometriosis, hemorrhagic connective tissue showing endometriosis, benign cyst. After all of that, he did the hysteroscopy and D and C.
That explains a lot of the pain I had. All of the adhesion removal from the pelvic floor and ligaments helped me tremendously, since I woke up in no pain. Even after the pain medication wore off, there was no leg pain, no back pain and no belly pain. There was bladder pain and my private area was inflamed from the catheter, but I was grateful!