BACKGROUND: Endometriosis with bowel involvement is the most
invasive form and can cause infertility, chronic pelvic pain and
bowel symptoms. Effective surgical treatment of endometriosis
requires complete excision of endometriosis and in same case may
require segmental rectosigmoid resection.
METHODS: Between December 1997 and October 2003, 55 patients with
rectovaginal endometriosis underwent a combined laparoscopic
vaginal technique. 30 patients were found at a follow-up and
underwent a telephone interview. The questionnaire covered
questions about symptoms related to recurrences of intestinal
endometriosis, dyspareunia, dysmenorrhea and pregnancy.
RESULTS: Twenty-seven of 30 (90%) women have no clinical symptoms
of reported recurrence of endometriosis. Two patients (6.6%) had
evidence of recurrence of bowel endometriosis. Dysmenorrhoea
disappeared in 28 (93.3%), dyspareunia in 26 (86.7%) and pelvic
pain in 27 (90%) patients. 17 patients (31%) tried to become
pregnant and 11 of these patients (65%) became pregnant: 9 patients
delivered healthy newborns, 18 pregnancies occurred and 19 healthy
children were born.
CONCLUSIONS: Despite the small number of follow-up patients, our
94-month follow-up data demonstrated that endometriosis with bowel
involvement and radical resection was associated with significant
reductions in painful and dysfunctional symptoms, a low recurrence
rate (6.6%) and high pregnancy rate (36.6%).
PMID: 20458487 [PubMed – indexed for MEDLINE]