[en] 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'.
Disciplines :
Reproductive medicine (gynecology, andrology, obstetrics)
Author, co-author :
Donnez, Jacques
NISOLLE, Michelle ; Centre Hospitalier Universitaire de Liège - CHU > Gynécologie-Obstétrique CHR
Casanas-Roux, Françoise
Bassil, Salim
Anaf, V.
Language :
English
Title :
Rectovaginal septum, endometriosis or adenomyosis: laparoscopic management in a series of 231 patients.
Canis, M., Wattiez, A., Pouly, J. L., Bassil, S., BouquetdeJoliniere, J., Chapron, C, Manhes, H., Mage, G. and Bruhat, M. A. (1993) Laparoscopic treatment of endometriosis. In Brosens, I. and Donnez, J. (eds), Endometriosis: Research and Management. Parthenon Publishing, UK, pp. 407-417
Donnez, J. and Nisolle, M. (1988) Appearances of peritoneal endometriosis. In Proceedings of the Third International Laser Surgery Symposium, Brussels, Belgium
Donnez, J., Nisolle, M. and Casanas-Roux, F. (1990) Endometriosisassociated infertility: Evaluation of preoperative use of Danazol, Gestrinone and Buserelin. Int, J. Fertil., 35, 297-301
Donnez, J., Nisolle, M. and Casanas-Roux, F. (1992) Three-dimensional architectures of peritoneal endometriosis. Fertil. Steril., 57, 980-983
Donnez, J., Nisolle, M., Casanas-Roux, F. and Clerckx, F. (1993) Endometriosis: rationale for surgery. In Brosens, I. and Donnez, J. (eds), Endometriosis: Research and Managemem. Panhenon Publishing, UK. pp. 385-395
Donnez, J., Nisolle, M., Casanas-Roux, F., Anaf, Y. and Smets, M. (1994) Laparoscopic treatment of rectovaginal septum endometriosis. In Donnez, J. and Nisolle, M. (eds). An Atlas of Laser Operative Laparoscopy and Hysteroscopy. Panhenon Publishing, UK, pp. 75-85
Hughesdon, P. E. (1957) The structure of endometrial cysts of the ovary, J. Obstet. Gynaecol. Br. Emp., 64, 481-487
Kelly, R. and Diamond, M. P. (1989) Laparotomy in inFertile patients (use of C02 laser). J. Reprod. Med., 34, 25
Koninckx, P. D. (1993) Deeply infiltrating endometriosis. In Brosens, I. and Donnez, J. (eds), Endometriosis: Research and Managemem. Panhenon Publishing, UK, pp. 437-446
Nezhat, C., Nezhat, F. and Pennington, E. (1992) Laparoscopic treatment of lower colorectal and infiltrative rectovaginal septum endometriosis by the technique of video laparoscopy. Br. J. Obstet. Gynaecol., 99, 664-667
Nisolle, M., Casanas-Roux, F. and Donnez, J. (1988) Histologic study of ovarian endometriosis after hormonal therapy. Ferril. Steril., 49, 423-426
Nisolle, M., Paindaveine, B., Bourdon, A., Berliere, M., CasanasRoux, F. and Donnez, J. (1990) Histologic study of peritoneal endometriosis in inFertile women. Ferril. Steril., 53, 984-988
Nisolle, M., Casanas-Roux, F., Anaf, V., Mine, J. M. and Donnez, J. (1993) Morphometric study of the stromal vascularization in peritoneal endometriosis. Ferril. Steril., 59, 681-684
Reich, H., McGlynn, F. and Salvat, J. (1991) Laparoscopic treatment of cul-de-sac obliteration secondary to retrocervical deep fibrotic endometriosis. Reprod. Med., 36, 516
Sampson, J. A. (1922) Intestinal adenomas of endometrial type. Arch. Surg., 5, 217
Zaloudek, C. and Norris, H. J. (1987) Mesenchymal tumors of the uterus. In Kurman, R. (ed.), Blaustein s Pathology of the Female Genital Tract. Springer-Verlag, p. 373
