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Human Reproduction, Vol. 11, No. 1, pp. 224-228, 1996
© 1996 European Society of Human Reproduction and Embryology

research-article

Stereometric evaluation of peritoneal endometriosis and endometriotic nodules of the rectovaginal septum

J. Donnez1, M. Nisolle, F. Casanas-Roux, P. Brion and N.Costa DaFerreira

Department of Gynaecology, Universite Catholique de Louvain, Cliniques Universitaires St Luc Avenue Hippocrate 10, B-1200 Brussels, Belgium

Correspondence: 1To whom correspondence should be addressed

A computerized morphometrical investigation was performed on endometriotic tissue from the peritoneum (n=225) and rectovaginal nodules(n=65) to compare histologically and stereologically the retorovaginal septum endometriotic nodule to peritoneal endometriosis. Mitotic activity, Stromal vascularization and the epithelium/stroma ratio were found to be significantly different in peritoneal and rectovaginal endometriosis. The evaluation revealed a major role of glandular epithelium in rectovaginal nodules where the stroma sometimes appeared absent around glandular epithelium. The study demonstrated opposite effects of gonadotrophin-releasing hormone agonists(GnRHa) and lynestrenol on the two lesions. Indeed, in peritoneal endometriosis, after GnRHa therapy, our study demonstrated a lower rate of mitosis and poor stromal vascularization. The same drug was unable to induce the same effects in the nodule vascularization. In conclusion, it is suggested that the rectovaginal adenomyotic nodule is a specific disease, different from peritoneal endometriosis. It is not the consequence of ‘deep infiltrating’ endometriosis but can probably develop from Müllerian rests present in the rectovaginal septum.

Key words: adenomyosis/endometriosis/peritoneal/rectovaginal nodule/stereometry


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