The uterus has been cut to display the endometrial cavity. The wall is slightly thickened and it is
difficult to be certain, by the naked eye, of the presence of adenomyosis described by the
Microscopist. Near the junction of the cervix and the body, there is a nodule some 2.5 x 2.0 cm.
which on the cut surface shows a number of discrete haemorrhagic areas. Microscopy of this area
confirmed the presence of endometriosis and suggested that the excised tissue included portion of
the bladder wall which was involved by the lesion.
This woman had had 4 previous pregnancies and over the year prior to hysterectomy had
suffered severe lower abdominal pain, beginning about the 3rd day of the cycle and lasting between
3 and 14 days. Over the same period she had noted painful contractions of the bladder following
emptying during the period in which she had abdominal pain.