Help! Trying to Decipher my Post-op Letter!

I need some help! I received my post-op letter yesterday (had my lap on 21st December), but some of the wording in it is just completely confusing! See below some of the things that I don't understand what they signify... :-/

- The Peritoneum was quite angry & red looking with pocketing suggestive of Endometriosis on the left side of the rectum & also on the right side wall

- The ureter had to be deflected upwards to excise the peritoneum on the left side from just below the ureter into the para rectal space on the left

I've tried Googling the above to find some answers, but I really can't come up with anything that helps :-(

I understand where the rectum is, obviously, but where on earth / what is the para rectal space & what is meant by my peritoneum being red & angry & the pocketing?!!

Help! x

4 Replies

  • I'm no surgeon but para is used to mean 'adjacent to' so they are referring to the space next to your rectum which seems as though it has had endometriosis excised from it.

    Pockets refer to patches or growths of possible endo and your peritoneum being angry and red suggests that it is inflamed or somehow different to a normal persons which wouldn't usually be red looking. The peritoneum is the lining which sits around your andominal cavity.

    Hope this helps a bit. Maybe someone else will have a different interpretation but that would be mine.

  • Thanks Batfoss!

    That does help a bit... I wish they would explain what would cause it to be red & inflamed though :-\ Will keep trying to research ;-)

  • Hi Laura

    The peritoneum is a very thin membrane that lines the pelvic cavity and then wraps round most of the pelvic organs. It has the appearance of two layers but is in fact continuous. There is a potential space between which is where the peritoneal fluid exists and would be where endo cells would be transported and deposited on the peritoneum if the retrograde menstruation theory for the origin of potential endo tissue is correct. In order for any cells to multiply and grow (proliferate) there needs to be a blood supply and the development of endo is associated with the formation of new blood vessels. So the presence of abnormally 'angry' red areas of peritoneum would suggest the establishment of a blood supply and the possibility of early endo even if it cannot yet be identified as such. When I had my diagnostic lap in one of the top rated endo centres my peritoneum was described as having angry-looking blood vessels but the specialist wasn't able to confirm the presence of endo until the biopsies he took confirmed it.

    Peritoneal pockets occur where there is a defect in the peritoneum involving folds and/or hollows in which endo can remain hidden and undiagnosed. Some evidence has indicated an association with the presence of pockets and women with endo. So the observations of a red, angry peritoneum with pocketing indicates early endo.

    The right side wall refers to the right side wall of the pelvis - the abdominal wall - so the peritoneal lining there had endo on it.

    The para rectal space is a triangular space above the ligament that attaches the cervix to the back wall (the Cardinal ligament) near to the bowel and ureter. I think he is describing that he had to move the ureter out of the way in order to excise the part of the affected left peritoneum that was on your bowel.


  • Hi Lindle,

    Thank you for this.. that makes a lot more sense now :-) But goodness, we are complex inside aren't we!

    One thing that I have never been able to figure out is a pain that I used to have on my right side, very low down on the front inside of my pelvis area near the hip bone, I would almost have described it as a 'deep' pain that if pressed on would send a shooting pain down the top of my leg, a bit like a trapped nerve! After the op the area where this used to be felt very 'grisly' & whilst the shooting pain has gone it still gives me twinges :-( The Gynae has said that I can see him any time in the next 6 months without a referral should I need to, but I want to try & give it sufficient time to heal, so am not really sure how long I should leave it!?

    Having high hopes that I won't need to go back again... so fed up of being prodded & poked!


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