Rectovaginal endometriosis : pain treatment options

Satu Tarjanne
2016 · W2309434633
article OA: green CC0
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⚙ AI-generated summary by claude@2026-06, 2026-06-06 ⓘ

This study found that laparoscopic surgery for rectovaginal endometriosis is safe and effective, with bowel resection and amenorrhea-inducing therapies protecting against recurrence, and excessive innervation contributing to pain.

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The provided text does not contain biomedical study content or research findings; it is an anti-scraping “Anubis” proof-of-work page stating that automated access is being blocked and explaining how the challenge works. No population, methods, results, or limitations relevant to endometriosis treatment are described in the excerpt. Because the actual paper content is inaccessible here (only the blocking page is shown), there is no basis to summarize the scientific work itself. This paper is centrally about endometriosis — rectovaginal endometriosis pain treatment options, based on the provided title, though the body text is not available for content-based summarization.

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Abstract

Endometriosis is a common gynecological disease affecting women in their best reproductive years. Deep infiltrating form of the disease, rectovaginal endometriosis (RVE), causes pain via mechanisms that are partly unknown. In symptomatic patients not responding to hormonal therapies, surgery is needed. Surgical treatment of RVE is challenging, and may require bowel resection. Currently, a laparoscopic approach is used in most RVE operations, bowel resections included. Recurrence rates following surgery vary between 5-30%. \n \nThis study was undertaken in order to acquire information on the long-term outcome of surgery for RVE, in particular factors affecting recurrence. Altogether 60 patients operated upon in 2002-2004 had a follow-up visit in our clinic, on average four years after the original operation. Symptom recurrence was evaluated by using symptom diaries. \n \nIn addition, we studied charts on 164 patients who had undergone bowel resection in 2004-2012. The laparoscopic approach to bowel resection was of special interest, with emphasis on collecting information on complications. \n \nIncreased innervation in endometriotic tissue may contribute to endometriosis-associated pain generation. We used immunohistochemistry to study the density of nerve fibers, and the effect of hormonal therapies on their density, in 45 samples obtained during RVE surgery. \n \nOur results showed that even though clinical recurrence developed in 35% of cases, symptom recurrence was rare. Bowel resection was protective as regards recurrence, as were all the forms of hormone and surgical therapy that resulted in amenorrhea. \n \nLaparoscopy offers a safe route for performing RVE surgery, and should be the primary approach even as regards colorectal resection in cases of RVE. We found that the rate of complications did not depend on the type of surgery (laparoscopy vs. laparotomy) but was more related to the experience of the surgeon. \n \nExcessive innervation was identified in the RVE specimens. This innervation may be one of the explanations for the severe pain that these patients experience. The density of nerve fibers was reduced among those patients who were using either combined oral contraceptives or progestins. \n \nIn conclusion, bowel resection may protect women from recurrences in cases of colorectal involvement. Following operative treatment for RVE, hormonal therapies aimed at amenorrhea should be administered to all women in order to protect them from symptom recurrence. Recurrent symptomatic disease, however, is very uncommon, and most patients greatly benefit from surgical treatment of RVE.
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Condition tags

endometriosisbowel_endometriosis

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