I finally got my surgical report. It’s been almost six weeks since my surgery. The word that is used often and throughout this report is significant. Did I mention this is my seventh surgery? Fourth and last with this doctor.
1. Chronic pelvic pain
2. Advanced endometriosis
3. Right adnexal cyst
He left out the fact that I couldn’t eat solid food without pain and bloody bowel movements around my menses.
1. Stage IV (it was only stage II in March) deep nodular endometriosis located on posterior uterine wall area/adenomyosis, rectosigmoid colon area, bilateral perirectal spaces and bilateral uterosacral ligament areas.
2. Extensive pelvic adhesions, including totally obliterated pouch of Douglas area
3. Right peritoneal inclusion cyst with chocolate cyst type of material
4. Menorrhagia pending pathological diagnosis
1. Operative laparoscopy with extensive lysis of adhesions including enterolysis
2. Bilateral ovarian neurolysis
3. Excision of right peritoneal inclusion cyst
4. Multiple deep nodular excision of stage IV endometriosis
5. Deep excision of the rectovaginal septum area of endometriosis
6. Re-creation of pouch of Douglas area
7. Application of Evicel
8. Diagnostic hysteroscopy
9. Fractional dilatation and curettage
Most of it sounds exactly like the last three surgeries with my usual “obliterated pouch of Douglas”.
Let’s define that! Obliterated to completely destroy, have no trace!
Pouch of Douglas is also know as the culdesac which is between the uterus and the vagina and the rectum!!! Can we say OUCH??? And it’s been EVERY FRIGGIN TIME!!! Apparently the reconstruction doesn’t help for too long. This, gets me very angry!
Then we also have the chocolate cyst on my right ovary, no mention of my left ovary at all in this report (I know it’s still there because I can feel which side I ovulate on every month and I’ve ovulated twice since surgery). This time I had a peritoneal inclusion cyst, caused by adhesions. That was the “pocket” seen on my ct scan.
The first thing he saw “upon gross visualization” was my significantly retroflexed (or bent) uterus (that he didn’t want to remove) and my completely obliterated cul de sac.
Ok, that sounds bad enough, right? It gets better, or badder?
From my completely obliterated pouch, they had to remove my omentum, a portion of my rectosigmoid colon and my small intestine. I’ll repeat, my small intestine was in that mess too! And from the pictures it just looked like when my baked ziti gets all mushy, the noodles fall apart and the cheese is all stringy, like a bomb went off in my abdomen. Sorry if I’ve ruined ziti for you, but it was gross!
My right ovary was attached to the pelvic sidewall. There was deep nodular endometriosis in the right perirectal space, posterior vaginal wall and rectovaginal septum.
There was a significant amount of adenomyosis was removed from the posterior (back) uterine wall (same uterus that is bent, that I wanted removed) as was endometriosis, or is that the same thing if adenomyosis is growing outside my uterus??? (FYI- that was the simplest definition of adeno I could find, but I have to correct Mayo, it doesn’t just “happen after having children”! Thanks for rubbing that in again).
Back to my rectosigmoid colon. They found the rest of it in my rectovaginal septum(deeply invaded by deep nodular Endo).
There was Endo found on my left uterosacral ligament again.
Then it goes on about the excision techniques: Bisectional, hydrodissection, cutting in multilayer fashion, deep excision,extensive lysis of adhesions, blah blah blah, I can’t even deal with that now. They did something with my culdesac and Evicel “for hemostasis”, to stop bleeding after excision.
And now, the ending.
The hysteroscopy. My uterus was 9cm, slightly enlarged (and don’t forget bent and riddled with adenomyosis, that I wanted removed). There was a “polypoid like structure in the fundus area of the uterus” that I wasn’t told about. Got my D & C and I was done.
At the post op the doctor told me I shouldn’t have any more surgeries.
Oh and everything biopsied was endometriosis. Lucky me.
I’m actually warn out writing this. There are no more words.