The clinical evolution of a case of deep endometriosis in postmenopause

Abstract

Objective: To report a case study of a patient with the evolution of postmenopausal deep endometriosis, as well as to discuss its particularities, low prevalence and scarcity in the scientific field. Case details: Patient, female, 49 years old, white, gestating one to 27 years of cesarean delivery. Reports dyspareunia, hypermenorrhea, pelvic and abdominal pain since adolescence, obtaining the diagnosis of endometriosis in adulthood. He has a history of multiple surgical approaches due to endometriosis, resulting in premature menopause and later requiring further surgery due to the emergence of deep endometriotic foci. Exams were requested to map the regions affected by the disease and subsequent planning of surgical bowel preparation. Exeresis of endometriotic foci and adhesions was performed by videolaparoscopic surgery, after a few days a new approach was necessary, resulting in an iliotilectomy due to endometriotic intestinal foci. The pathological examination confirmed endometriosis in both approaches and the patient currently has an excellent prognosis, with no complaints. Final considerations: Endometriosis is a pathology that, when diagnosed early and with adequate multidisciplinary follow-up, can avoid complications and multiple approaches. This pathology in post-menopause, although rare, must be considered, so that it can have a diagnosis and therapy as early as possible.