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Human Reproduction, Vol. 10, No. 3, pp. 630-635, 1995
© 1995 European Society of Human Reproduction and Embryology

research-article

Surgery: Rectovaginal septum, endometriosis or adenomyosis: laparoscopic management in a series of 231 patients

J. Donnez1, M. Nisolle, F. Casanas-Roux, S. Bassil and V. Anaf

Department of Gynaecology, Catholic University of Louvain, Cliniques Universitaires St Luc Avenue Hippocrate 10, 1200 Brussels, Belgium

Correspondence: 1To whom correspondence should be addressed

A series of 231 cases of deep-infiltrating endometriosis of the rectovaginal septum is presented. Laparoscopic procedures with excision of deep fibrotic endometriotic nodules were performed in all cases. In three cases, the bowel lumen was entered. No other peri-operative complications were observed. Three cases of urinary retention were reported. The nodule resection resulted in considerable pain relief. Histologically, the rectovaginal nodule was similar to an adenomyoma. Indeed it was a circumscribed nodular aggregate of smooth muscle and endometrial glands. This form of disease must be considered as a specific disease which originates from the Mullerian rests present in the rectovaginal septum and we suggest that it be called ‘rectovaginal adenomyosis’.

Key words: adenomyosis/endometriosis/laparoscopic surgery/nodule/rectovaginal septum


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