Conservative Management versus Rectal Resection in Deep Infiltrating Endometriosis of the Rectum

Ahmed K. Eltaher, Mohamed Mahmoud Almeniwy, Mohamed Adel Saleh, Alaa Haggag, Ahmed S. Allam, Ola A. Harb, Walid S.H. Elsayed, A. Al-Ja’afreh Abdallah, Mahmoud Kotb, M. Omara, Ahmed Metwally Elkattawy
In: Journal of Coloproctology · 2026 · vol. 46(01) , pp. 001–005 · doi:10.1055/s-0045-1814452 · W7161853642
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Conservative rectal shaving or disc excision for deep infiltrating endometriosis yielded better short-term digestive and urinary outcomes compared to segmental colorectal resection, with lower risks of stenosis, fistula, and bladder dysfunction.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This randomized comparative study enrolled 60 women aged 20–40 years with deep infiltrating rectal endometriosis confirmed by clinical evaluation and imaging (including MRI), and compared conservative rectal surgery (shaving and/or disc excision) versus segmental radical colorectal resection, assessing digestive and urinary outcomes up to 24 months. The authors found no statistically significant baseline differences between groups, and reported that rectal stenosis, and postoperative complications including recto-vaginal fistula and bladder dysfunction requiring long-term self-catheterization, were more common after segmental resection. Functional outcomes showed low reported constipation in both groups, while frequent bowel movements were more frequent after segmental resection, with similar reported defecation pain rates. A key caveat is that the paper provides limited detail in the excerpt about outcome measurement methods for some secondary scores and does not clearly state effect sizes for all comparisons. This paper is centrally about endometriosis — it directly compares conservative versus segmental rectal surgery for deep infiltrating rectal endometriosis and reports related digestive and urinary outcomes.

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Abstract

Abstract Rectal deep infiltrating endometriosis has become an increasing problem with two main management strategies; radical surgery by segmental colorectal resection, and a conservative surgery that includes removal of the lesion with rectal conservation. Aim was to compare between conservative management of deep infiltrating endometriosis of the rectum by shaving or disc excision and segmental radical colorectal resection regarding short term patients' outcome, digestive and urinary outcomes. Patients and methods: Included 60 patients with deep endometriosis infiltrating the rectum were randomly divided into 2 equal groups the first group underwent conservative surgery by either rectal shaving or disc excision and the second group underwent colorectal resection. We showed that rectal stenosis was more in the group of patients who are managed by segmental resection (some of patients with secondary stenosis underwent secondary resection of colo-rectum and the others under general anesthesia had endoscopic dilatation. Risks of postoperative complication, as recto-vaginal fistula and dysfunction of the urinary bladder which required long term self-catheterization were more common in the patients who underwent segmental resection. Constipation is recorded in (11.1%) of the conservative group and in (9.1%) of the segmental resection group, frequent bowel movements is recorded in (8%) the conservative group and in 7 (22%) of the segmental resection group, defecation pain is recorded in (19%) of the conservative group and in 6 (19%) the segmental resection group, and involuntary loss of gas or stools were recorded in (12%) the conservative group and in (30%) in the segmental resection group. Spontaneous conception was recorded in (70%) and (60%) of patients in both groups respectively. we showed a slightly better outcome of patient who underwent conservative surgery for deep infiltrating endometriosis of rectum management and it might improves functional digestive and urinary outcomes, in comparison to resection of colo-rectum.

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Outcome instruments

VAS-pain

Condition tags

endometriosisdie_deep_infiltrating

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (26)

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last seen: 2026-06-10T17:14:06.276822+00:00
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