Chronic pelvic pain: a rare complication following a large-loop excision of the transformation zone

Abstract

This is the unique report of a patient with deep-seated, left-sided pelvic pain following a large-loop excision of the transformation zone (LLETZ) for cervical intraepithelial neoplasia III. She transpired to have a definite diagnosis of pelvic varicosities which were only on the left side. Our surmise was that the varicosities had risen on the back of an arteriovenous malformation following her LLETZ performed by a colleague. The first attempted treatment was radiologic embolization. When this failed, she had a formal surgical procedure, and the left unilateral varicosities were ligated. Her pain ceased entirely thereafter, and she remained pain free at her 1-year review.

Comparison of Loop Electrosurgical Conization with One or Two Passes in High-Grade Cervical Intraepithelial Neoplasias

“…Thermal damage of tissues can also make margin assessment difficult [9,10] . Additionally, the small dimensions of the vaginal fundus are a limiting factor, due to the fact that during the procedure the loop must not touch the vaginal walls (to avoid lesions of the bladder, rectum and ureters) [11] .…”