Laparoscopic resection of deeply infiltrating endometriosis of the rectovaginal septum: effect on pelvic pain

Adrian Kwok, Alan Lam, Robert M. Ford
In: Gynaecological Endoscopy · 2001 · vol. 10(1) , pp. 7–11 · doi:10.1046/j.1365-2508.2001.00412.x · W2045877792
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Laparoscopic resection of rectovaginal septum endometriosis significantly improved dysmenorrhea, pelvic pain, dyspareunia, and dyschezia scores in 46 patients an average of 8.8 months post-surgery.

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Abstract

Objective To compare pain scores for dysmenorrhoea, intermenstrual pelvic pain, dyspareunia and dyschezia before and after resection of endometriotic nodules from the rectovaginal septum. Design Retrospective review of case records in 46 patients who had resection of deeply infiltrating endometriotic nodules from the rectovaginal septum. Adhesiolysis and treatment of endometriomas were performed where necessary. Two patients underwent laparoscopic uterosacral nerve ablation. Results The average patient age was 32 years. The presenting symptoms were: severe dysmenorrhoea (70%), pelvic pain (65%), dyspareunia (28%), dyschezia (30%) and infertility (28%). Improvements in pain scores at follow up (mean 8.8 months) were 59%, 87%, 77% and 86%. Only one of the 13 patients with infertility conceived in the follow‐up period. Conclusion This retrospective analysis suggests that the laparoscopic resection of rectovaginal endometriosis is effective in improving the different facets of pelvic pain. We believe that the development of a standardized scoring system to assess pain resulting from endometriosis would be helpful, as well as prospective studies to evaluate different treatment modalities.

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Condition tags

endometriosisbowel_endometriosisdysmenorrheadyspareuniainfertility

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