What Does Severe Pain In The Pelvic Area Indicate?

I m 53 and have had very painful pelvic pain for 4 yrs. I ve seen just about every type of Dr. for this type of pain and I finally was told low grade rectocele and cystocele. I went to see a gyno to be fit for a pessarie. Upon examination he came to the conclusion that I had no signs of prolapse just a hormone deficientcy and he believes a case of endometriosis. He prescribed blood work and an ultrasound. On my Ultrasound Gyn, Transvaginal, it states I have a uterine fibroid which I knew I had and had a biopsy a few years ago and it was benign. This is the 2nd ultrasound that can t find my right ovary. The first ultrasound a few years ago said I was constipated. This new ultrasound says it s excessive bowel in Rt. adnexa. He insisted the fibroid is causing the pain. but the majority of the pain is in my rectum area. He said I need to get on the hormones first to see how I do and that a laparoscope nay not be needed. The last time I saw him he said Aid have to have one and a total hysterectomy along with laser surgery of affected areas. Is the view look a rectocele or bowel obstruction? All he did was prescribe me hormone which I don t get till next month and his personal vitamins. What s your opinion?