A case of laparoscopic adhesiolysis and cutting of a cord like structure of the vaginal stump for persistent pain after hysterectomy

Abstract

Objective: Some patients are suffered from persistent pain after hysterectomy and the reason of the pain is usually unknown. We experience a case of laparoscopic adhesiolysis and cutting of vaginal stump for persistent pain after hysterectomy. Case: A 22 years old female patient underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy for gender identity disorder in a foreign country. She complained lower abdominal pain soon after surgery and it persisted. The diagnosis was infection of the vaginal stump for the first, but the pain was not resolved after treatment with a course of antibiotics. The point of the tenderness was on the left side of the half of the vaginal stump. Blood examination, ultrasonography, upper and lower endoscopy, and CT did not reveal the reason of persistent pain. Diagnostic laparoscopy revealed the existence of adhesion and a cord like structure of the vaginal stump. The pain was diminished after laparoscopic adhesiolysis and cutting the cord like structure of the vaginal stump. Conclusion: Diagnostic laparoscopy can be of benefit to abdominal pain with unknown reason. Laparoscopic adhesiolysis and cutting the cord like structure of the vaginal stump were effective to the resolve of the pain of this patient.