[en] OBJECTIVE: Laparoscopic procedure with excision of deep fibrotic endometriotic nodules of the rectovaginal septum and histological study of the lesions.
SETTING:
An academic teaching hospital.
PARTICIPANTS:
A series of 500 women undergoing laparoscopy for pelvic pain or infertility.
RESULTS:
Laparoscopic (n = 497) and laparotomic (n = 3) excision of endometriotic nodules resulted in considerable pain relief. Histologically the rectovaginal nodule was similar to an adenomyoma as it was a circumscribed nodular aggregate of smooth muscle and endometrial glands and stroma. The variations in oestrogen receptor and progesterone receptor content suggested a regulatory mechanism different from that of eutopic endometrium.
CONCLUSION:
This form of disease should be considered as an entity distinct from peritoneal and ovarian endometriosis, and originating from the Müllerian rests present in the rectovaginal septum.
Disciplines :
Reproductive medicine (gynecology, andrology, obstetrics)
Author, co-author :
Donnez, Jacques
NISOLLE, Michelle ; Centre Hospitalier Universitaire de Liège - CHU > Gynécologie-Obstétrique CHR
Gillerot, Stépane
Smets, Mireille
Bassil, Salim
Casanas-Roux, Françoise
Language :
English
Title :
Rectovaginal septum adenomyotic nodules: a series of 500 cases.
Donnez J, Nisolle M, Casanas-Roux F. Three-dimensional architectures of peritoneal endometriosis. Fertil Steril 1992; 57: 980–983.
Nisolle M. Peritoneal, ovarian and rectovaginal endometriosis are three distinct entities. These d’ Agregation de l ‘Enseignement Superieur, Universiste Catholique de Louvain, 1996.
Donnez J, Nisolle M. Appearances of peritoneal endometriosis. In Proceedings of the Third International Laser Surgery Symposium, Brussels, Belgium, 1988.
Nisolle M, Paindaveine B, Bourdon A, Berliere M, Casanas-Roux F, Donnez J. Histologic study of peritoneal endometriosis in infertile women. Fertil Steril 1990; 53: 984–988.
Nisolle M, Casanas-Roux F, Anaf V, Mine JM, Donnez J. Morphometric study of the stromal vascularization in peritoneal endometriosis. Fertil Steril 1993; 59: 681–684.
Hughesdon PE. The structure of endometrial cysts of the ovary. J Obstet Gynaecol Br Emp 1957; 64: 481–487.
Donnez J, Nisolle M, Gillet N, Smets M, Bassil S, Casanas-Roux F. Large ovarian endometriomas. Hum Reprod 1996; 11: 641–646.
Donnez J, Nisolle M, Casanas-Roux F. Endometriosis—associated infertility: Evaluation of preoperative use of Danazol, Gestrinone and Buserelin. IntJ Fertil 1990; 35: 297–301.
Reich H, McGlynn F, Salvat J. Laparoscopic treatment of cul-de-sac obliteration secondary to retrocervical deep fibrotic endometriosis. Reprod Med 1991; 36: 516.
Koninckx PD. Deeply infiltrating endometriosis. In: Brosens I, Donnez J, editors. Endometriosis: Research and Management. Carnforth : Parthenon Publishing, 1993:437–446.
Nezhat C, Nezhat F, Pennington E. Laparoscopic treatment of lower colorectal and infiltrative rectovaginal septum endometriosis by the technique of video laparoscopy. Br J Obstet Gynaecol 1992; 99: 664–667.
Canis M, Wattiez A, Pouly JL et al. Laparoscopic treatment of endometriosis In: Brosens I, Donnez J, editors. Endometriosis: Research and Management. Carnforth : Parthenon Publishing, 1993: 407–417.
Donnez J, Nisolle M, Casanas-Roux F, Clerckx F. Endometriosis: Rationale for surgery. In: Brosens I, Donnez J, editors. Endometriosis: Research and Management. Carnforth : Parthenon Publishing, 1993: 385–395.
Donnez J, Nisolle M, Casanas-Roux F, Anaf V, Smets M. Laparoscopic treatment of rectovaginal septum endometriosis. In: Donnez J, Nisolle M, editors. An Atlas of Laser Operative Laparoscopy and Hysteroscopy. Carnforth : Parthenon Publishing, 1994: 75–85.
Donnez J, Nisolle M. Advanced laparoscopic surgery for the removal of rectovaginal septum endometriotic or adenomyotic nodules. Baillieres Clin Obstet Gynecol 1995; 9: 769–774.
Donnez J, Nisolle M, Casanas-Roux F, Bassil S, Anaf V. Rectovaginal septum endometriosis or adenomyosis: Laparoscopic management in a series of 231 patients. Hum Reprod 1995; 10:630–635.
Donnez J, Nisolle M. Peritoneal endometriosis, ovarian endometriomas and “endometriotic” nodules of the rectovaginal septum are three distinct entities. References en Gynecologie Obstetrique 1995; 3: 121–123.
Sternberger LA, Hardy Ph Jr, Cuculis JJ, Meyere HG. The unlabeled antibody-enzyme method of immunohistochemistry. Preparation and properties of soluble antigen-antibody complex (horseradish peroxydase—antihorseradish peroxydase) and its use in identification of spirochetes. J Histochem Cytochem 1970; 18: 315–333.
Nisolle M, Casanas-Roux F, Wyns Ch, De Menten Y, Mathieu PE, Donnez J. Immunohistochemical analysis of oestrogen and progesterone receptors in endometrium and peritoneal endometriosis: A new quantitative method. Fertil Steril 1994; 62: 751–759.
McCarty KS Jr, Miller LS, Cox EB, Konrath J, McCarty KS Sr. Estrogen receptor analyses: Correlation of biochemical and immuno- histochemical methods using monoclonal antireceptor antibodies. Arch Pathol Lab Med 1985; 109: 716–721.
Zaloudek C, Norris HJ. Mesenchymal tumors of the uterus. In: Kurman R, editor. Blaustein’s Pathology of the Female Genital Tract. London : Springer-Verlag, 1987: 373–408.
Hirama Y, Ochiai K. Estrogen and progesterone receptors of the out-of-phase endometrium in female infertile patients. Fertil Steril 1995; 63: 984–988.
