Indication:
Performed for Infertility or pain in lower abdomen during menstrual period and painful sexual relations.
Objective:
Dysmenorrohea, Dysparenunia & pelvic pain & Infertility are the presenting symptoms. Chocolate cysts may be found in Infertility patient during trance vaginal USG evaluation. Endometriosis is the commonest cause of Infertility during Laparoscopy. Pigmented & white fibrotic lesions are the two different varieties of lesions. Endometriosis is poorly detected during Laparoscopy leads to more than 2-3 Laparoscopy of infertility patient without result. Endometriosis needs to be better address during Laparoscopy, as residual diseases leads to recurrence & Infertility. Most rewarding results are achieved following Laparoscopic surgery with pregnancy rate from 50 to 70% in different series for chocolate cyst with Endometriosis.Cystectomy should be preferred over simple drainage for preventing reoccurrence. But if we feel that cystectomy dissection is too difficult & likely to destroy many normal ovarian follicles, we do drainage & bipolar fulguration of internal surface of chocolate cyst. Rectovaginal endometriosis is carefully evaluated during Laparoscopy. Right cleavage & proper dissection of recto-vaginal nodule for her pain relief is paramount importance.