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Objective: To evaluate clinical outcomes associated with the resection of both endometrioma and posterior broad ligament (PBL) among women with PBL adhesion associated with endometrioma., Methods: Between January 2007 and December 2009 at the Villanova Hospital, Florence, Italy, a prospective trial was conducted on 99 consecutive patients with unilateral or bilateral endometrioma who underwent laparoscopic ovarian cystectomy by a stripping technique and homolateral PBL resection where PBL adhesion was associated with endometrioma. The prevalence of PBL adhesion and endometriosis, the association between PBL endometriosis and pain, and the recurrence of endometrioma and pain were evaluated. All data were analyzed with Prism software., Results: Among 124 endometriomas treated by concomitant PBL resection, the PBL was not affected by adhesions in only 2% of patients. PBL endometriosis was superficial in 36 (29.5%) and deep in 86 (70.5%) of the histologic preparations; deep endometriosis correlated with preoperative pain. At 1-year follow-up, endometrioma had recurred in 7 patients; the main symptom reported was mid-cycle pain (24 patients, 24%; P=0.0007)., Conclusion: Ovarian endometriosis was often (98%) associated with PBL endometriosis; deep endometriosis of PBL correlated with pain symptoms. Although PBL resection increased the incidence of mid-cycle pain, it was associated with low recurrence of endometrioma., (Copyright © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.)

Broad ligament adrenal rests are well known. A case of adrenal rest external to the surface of the broad ligament and adjacent to the fallopian tube is reviewed, with specific emphasis on its histogenesis. The rest is associated with a foreign body, and it is suggested that it has arisen as a secondary development of celomic epithelial metaplasia.

The main underlying pathology of the Allen Masters syndrome is based on lacerations of the broad ligament. This sometimes incapacitating disease is expressed by persistent pelvic pain, dyspareunia and menstrual disturbances. Treatment modes employed hitherto consisted of either suturing the peritoneal defect or of hysterectomy. We have treated four patients by simple fulguration of the peritoneal laceration, performed during laparoscopy. Results were excellent. It is suggested that this treatment mode may replace more extensive surgery.