Is painful rectovaginal endometriosis an intermediate stage of rectal endometriosis?

Roman H, Horace Roman, Alexis Gromez, Gromez A, Patrick Hochain, Hochain P, N. Marouteau-Pasquier, Marouteau-Pasquier N, Nolwenn Marouteau-Pasquier, Tuech JJ, Jean-Jacques Tuech, Jean‐Jacques Tuech, Resch B, B. Resch, Benoit Resch, Marpeau L, Loı̈c Marpeau, Loic Marpeau
Fertility and sterility · 2007 · vol. 90(4) , pp. 1014–1018 · doi:10.1016/j.fertnstert.2007.07.1388 · PMID:18054002 · W1975850727
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This paper investigates whether painful rectovaginal endometriosis represents an intermediate stage in the development of rectal endometriosis.

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Abstract

ObjectiveTo compare the history of pain complaints of women presenting rectovaginal and rectal endometriosis to show that rectovaginal locations may progress to a rectal involvement of the disease.DesignRetrospective comparative study.SettingDepartment of Gynecology and Obstetrics, University Hospital Rouen, France.Patient(s)Thirty-two patients with rectovaginal endometriosis and 16 patients with rectal involvement.Intervention(s)Standardized questionnaires recording the clinical history of painful deep endometriosis up to diagnosis.Main outcome measure(s)Length of time from onset of pain to diagnosis, types of pain, disability related to the pain, and number of physicians consulted before the diagnosis was made.Result(s)Women with rectal endometriosis had an earlier onset of dysmenorrhoea. The age of dysmenorrhoea and the length of time between the onset of the first pain to the first time that the endometriosis was suspected were significantly increased in women with rectal endometriosis. Pain during defecation was more frequent in patients with rectal endometriosis. Women consulted an average of three physicians before the endometriosis diagnosis was suggested. A nongynecologist physician made the diagnosis of rectovaginal and rectal endometriosis in respectively 26% and 31% of cases.Conclusion(s)Rectal endometriosis is associated with an earlier onset and a longer history of painful symptoms until the diagnosis was made when compared with rectovaginal endometriosis locations. These observations support the hypothesis that rectovaginal location may be an intermediate stage of rectal endometriosis.

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Condition tags

dysmenorrheaendometriosisbowel_endometriosis

MeSH descriptors

Dysmenorrhea Dysmenorrhea Endometriosis Endometriosis Rectal Diseases Rectal Diseases Vaginal Diseases Vaginal Diseases Adult Disease Progression Dysmenorrhea Endometriosis Female Humans Rectal Diseases Vaginal Diseases

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