Abstract

Vaginal vault endometriosis, a very rare complication of hysterectomised women with a prior history of endometriosis or adenomyosis. We the case a case of a 42-year-old a multiparous woman who underwent hysterectomy for the erosion of cervix. She developed bleeding per vaginum after 3 years of surgery. On examination, around 2 cm growth was noticed on the vault. The entire growth was excised, and histopathology of the growth revealed endometriotic tissue suggestive of vault endometriosis. After the excixion of the growth, the patient reported no further episodes of bleeding. Injection Leuprolide acetate was given as maintenance therapy for 3 months.

• 1.   World Health Organization. Endometriosis. World Health Organization. Published March 24, 2023. https://www.who.int/news-room/ fact-sheets/detail/endometriosis
• 2.   Giudice LC. Endometriosis. New England Journal of Medicine. 2010;362(25):2389-2398. doi:https://doi.org/10.1056/nejmcp1000274
• 3.   Della Corte L, Di Filippo C, Gabrielli O, et al. The Burden of Endometriosis on Women’s Lifespan: A Narrative Overview on Quality of Life and Psychosocial Wellbeing. International Journal of Environmental Research and Public Health. 2020;17(13):4683. doi:https://doi. org/10.3390/ijerph17134683.
• 4.   Limbachiya D, Tiwari R, Kumari R. Vault Endometriosis: Detailed Step-by-Step Laparoscopic Surgical Management Technique. JSLS : Journal of the Society of Laparoscopic & Robotic Surgeons. 2021;25(4):e2021.00057. doi:https://doi.org/10.4293/jsls.2021.00057.
• 5.   Lee HJ, Park YM, Jee BC, Kim YB, Suh CS. Various anatomic locations of surgically proven endometriosis: A single-center experience. Obstetrics &Gynecology Science. 2015;58(1):53. doi:https://doi.org/10.5468/ ogs.2015.58.1.53.
• 6.   Wang Y, Nicholes K, Shih IM. The Origin and Pathogenesis of Endometriosis. Annual Reviewof Pathology: Mechanisms of Disease. 2020;15(1):71-95. doi:https://doi.org/10.1146/ annurev-pathmechdis-012419-032654.
• 7.   Rana N, Rotman C, Hasson HM, Redwine DB, Dmowski WP. Ovarian remnant syndrome after laparoscopic hysterectomy and bilateral salpingo-oophorectomy for severe pelvic endometriosis. The Journal of the American Association of Gynecologic Laparoscopists. 1996;3(3):423-426. doi:https:// doi.org/10.1016/s1074-3804(96)80075-2
• 8.   Chen X, Zhu J. Case Report Vaginal cuff endometriosis after laparoscopic-assisted vaginal hysterectomy: a case report and literature review. Int J Clin Exp Med. 2018;11(6):6336-6339. Accessed September 2, 2024. https://e-century.us/files/ijcem/11/6/ ijcem0064096.pdf
• 9.   Choi CH, Kim JJ, Kim WY, Min KW, Kim DH. A rare case of post-hysterectomy vault site iatrogenic endometriosis. Obstetrics &Gynecology Science. 2015;58(4):319. doi:https://doi.org/10.5468/ ogs.2015.58.4.319
• 10.   Chauhan S, More A, Chauhan V, Kathane A. Endometriosis: A Review of Clinical Diagnosis, Treatment, and Pathogenesis. Cureus. 2022;14(9). doi:https://doi.org/10.7759/ cureus.28864
• 11.   F Nezhat, D Admon, Seidman D, CH Nezhat, C Nezhat. The incidence of endometriosis in posthysterectomy women. The Journal of the American Association of Gynecologic Laparoscopists. 1994;1(4):S24-S25. doi:https:// doi.org/10.1016/s1074-3804(05)80949-1.
• 12.   Roy SD, Bhandal M. Endometriotic Vaginal Vault Nodule Causing Posthysterectomy Vaginal Bleeding. Journal of Minimally Invasive Gynecology. 2017;24(4):522-524. doi:https:// doi.org/10.1016/j.jmig.2016.09.010.

Data Sharing Statement

Funding