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Endometriosis is a painful chronic disorder in premenopausal period that causes severe pelvic pain. It could be problematic for both the patient and physician since routine analgesic drugs may not resolve the symptoms. Therefore, various destructive surgical treatments are used in these patients and presacral neurectomy is one of the best and most recommended surgical methods. This paper reports pre sacral neurectomy operation that was performed in Sari Imam Khomeini Hospital for the first time on a 31-year-old woman suffering from severe mid pelvic pain. She was resistant to treatment but favorable results were observed after the operation.

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 Menstrual disorders are common in puberty, but they are of great concern to patients when presented with primary amenorrhea. This paper reports the case of a 17-year-old single female with secondary sexual characteristics and a suspicious mass in pelvic floor. She also complained from chronic pelvic pain. In laboratory tests, the hormone levels were normal and ultrasound scan showed a 50 to 89 mm hypoechoic adnexal mass. Computerized Tomography scan and Magnetic resonance imaging also confirmed the ultrasound findings. Due to the suspicious nature of the mass and chronic pain, the patient was subject to laparotomy, but was unwilling to undergo surgery, so, she was treated with oral estrogen and progesterone for 21 days. After discontinuation of medication, the first menstrual bleeding occurred. After the bleeding period (nine days), ultrasound scan was performed and no lump or lesion were reported. In cases where the patient has primary amenorrhea, despite the presence of pelvic mass, in case of normal laboratory tests and physical examination, a short term period with contraceptive pills is recommended.