Dysmenorrhoea and Adnexal Cysts - A Rare Presentation of Tarlov Cysts in the Pelvis

A 41 year old, married for 20 years, presented on 28th May, 2013 with history of dysmenorrhoea, deep dyspareunia, and pelvic pain for the past 6 months. She was nulliparous and practiced contraception by using condoms. Her menstrual pattern was essentially normal and the pain occurred mainly on the first two days of her period. Initial vaginal ultrasound scanning revealed multiple adnexal cysts on both sides of the pelvis (Figure 1a) with the largest one measured at 5 cm on the left. Bimanual pelvic examination elicited tenderness over the uterosacral ligaments and demonstrated the presence of the cystic adnexal masses. The initial diagnosis was probable ovarian endometrioma and pelvic endometriosis. Laparoscopy was performed with a view to excise any endometriotic lesions and to perform ovarian cystectomy on 1st June, 2013. Except for a small left ovarian dermoid that was removed at the operation, the uterus, and tubes, right ovary and uteroscral ligaments Abstract