a.What is the diagnosis for the patient and Is this a diagnosis with a ‘cure’?b.The tissue in itself is considered benign, but it is invasive. Suggest a reason as to how that could be contributing to the intense pain felt by the patient.c.Adhesions between the organs make the space ‘rigid’. How is that related to the discomfort during defecation and the pain during intercourse? To establish the extent of the suspected condition, diagnostic imaging begins with a transvaginal ultrasound. Thisindicates the presence of anomalous tissue in the vesiculocervical space, with numerous masses seen in the recto-vaginal space (pouch of Douglas), and there is also evidence of a cyst on an ovary. The presence of masses indicatedon the ultrasound can only be fully verified with exploratory laparoscopy.In the intervening time, the patient was treated using prescription ibuprofen, and dienogest (Visanne), which re-duces growth of the tissue. These treatments are not only designed to treat symptoms, but to also improve surgicaloutcomes.The laparoscopic investigative surgery was performed a few months later during a period of vacation from University.The laparoscopy allowed for staging of the condition, as well as allowing interventions to be performed simultane-ously. Excision of any aberrant tissue visualized was attempted where possible, and some tissue was treated usinglaser excision. The presence of adhesions was noted, but the surgery is more extensive and has more risks, and wastherefore delayed. The damage to the ovary and fallopian tube was also not addressed at this stage as the patientwill need to make decisions about further interventions due to the impact on fertility.Postoperatively, the patient had relief from most of the pain associated with the condition, and continued theVisanne for continued management. As excision of some of the tissue cut through some of the rectal adhesions,defecation did become easier. The patient will be monitored regularly as repeat procedures and more invasive ap-proaches will be required in the future.

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. What is the diagnosis for the patient and Is this a diagnosis with a ‘cure’? b.