Female 40 years old with a history of endometriosis status post TAH, BSO and resection of endometrial implants on bladder/ureteral reanastomosis and reimplantation. Now with pelvic pain, pelvic mass, pain and incontinence with intercourse. PELVIS:UTERUS, ADNEXA: A T2 hypointense mass extending from the vaginal cuff and invading the bladder wall measures 5.3 x 2.6 cm (series 5, image 19) and is compatible with endometriosis. An additional cystic lesion (series 5, image 28) and numerous other peritoneal implants of endometriosis are seen with the most prominently between the rectum and sigmoid colon (series 5, image 39) and in the dependent portions of the pelvis.Status post hysterectomy and bilateral salpingo-oophorectomy.BLADDER: The bladder is invaded by endometriosis as described above.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
The largest focus of endometriosis extends from the vaginal cuff and invades the urinary bladder. Multiple additional endometrial implants are also seen. 