Abstract
A case of intractable endometriosis treated with raloxifene is presented. A 30 y.o. gravida 0 with infertility presented with worsening pelvic pain, hematuria, cyclic bleeding and pain from the umbilicus. Pelvic examination revealed a non-mobile, tender uterus and adnexa. Ultrasound confirmed normal ovaries but revealed a 2 cm bladder floor nodule. Cystoscopy confirmed an extrinsic bladder-wall lesion for which she underwent a trans-urethral resection. Pathology returned a diagnosis of endometriosis. The patient was placed on depot leuprolide during the postoperative bladder drainage and healing period and beyond. During the 6 months of leuprolide treatment, the patient complained of severe hot flashes, somewhat ameliorated by addition of low dose estrogen starting in the fourth month, nausea, mood lability and constant spotting. An endometrial biopsy was benign. With continuing pelvic pain, she refused further medical therapy.
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