Endometriose des Septum rectovaginale: Histopathologische Rechtfertigung für die Darmresektion

Achim Schneider, Andreas Kavallaris, Philipp Klemm, R Kühne-Heid, C. Köhler
In: 54. Kongress der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe · 2003 · pp. 162–166 · doi:10.1007/978-3-642-18257-0_43 · W112050686
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-13 ⓘ

This paper discusses rectovaginal endometriosis, a severe form of endometriosis where surgical removal of the endometriotic nodule is the only chance for healing due to a lack of estrogen receptors.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

The paper discusses rectovaginal endometriosis of the rectovaginal septum and provides a histopathological rationale for performing bowel resection, framing rectovaginal disease as a particularly severe form of endometriosis. It reviews the proposed embryonic rest theory for pathogenesis and contrasts this form with more common extragenital endometriosis that may be treatable hormonally due to different receptor profiles. A major claimed limitation is that rectovaginal endometriosis is associated with a near-complete absence of estrogen receptors, leaving surgery as the only chance for cure, implying a restricted therapeutic context. This paper is centrally about endometriosis — it focuses on rectovaginal septum endometriosis and the histopathological justification for bowel resection.

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Zusammenfassung Unter Endometriose versteht man das heterotope ortsfremde Auftreten von Gewebe, welches der originären Gebärmutterschleimhaut morphologisch und funktionell ähnlich ist. Die funktionelle Ähnlichkeit bedeutet, daß auch die Endometrioseherde den zyklischen hormonellen Änderungen unterworfen sind. Eine der schwersten Formen der Endometriose ist die rektovaginale Endometriose.Hier wird als Entstehungstheorie die sogenannte Embryonalresttheorie favorisiert, wobei Restepithel der Müller’- schen Gänge durch Metaplasie transformiert wird.Während die häufigere Form der extragenitalen Endometriose durch Verschleppung von Endometriosezellen ins Beckenperitoneum zustande kommt und hormonell behandelt werden kann, besteht bei der rektovaginalen Endometriose durch des nahezu vollständige Fehlen von Östrogenrezeptoren nur eine Chance der Heilung, wenn der Endometrioseknoten chirurgisch entfernt wird [4]. Preview Unable to display preview. Download preview PDF. Similar content being viewed by others Literatur Coronado C, Franklin RR, Lotze EC, Bailey HR, Valdes CT (1990) Surgical treatment of symptomatic colorectal endometriosis. Fertil Steril 53:411–416 Crosignani PG, Vercellini P, Biffignandi F, Costantini W, Cortesi I, Imparato E (1996) Laparoscopy versus laparotomy in conservative surgical treatment for severe endometriosis. Fertil Steril 66: 706–711 Donnez J, Nisolle M, Casanas-Roux F, Bassil S, Anaf V (1995) Rectovaginal septum, endometriosis or adenomyosis: laparoscopic management in a series of 231 patients. Hum Reprod 10: 630–635 Donnez J, Nisolle M, Gillerot S, Smets M, Bassil S, Casanas RF (1995) Rectovaginal septum adenomyotic nodules: a series of 500 cases. Br J Obstet Gynaecol 104:1014–1018 Garry R, Clayton R, Hawe J, Northern Endometriosis Centre St JUHL (2000) The effect of endometriosis and its radical laparoscopic excision on quality of life indicators. Br J Obstet Gynaecol 107: 44–45 Gray LA (1973) Endometriosis of the bowel: role of bowel resection, superficial excision and oophorectomy in treatment. Ann Surg 177: 580–587 Koninckx PR, Donders G, Vandecruys H (2000) Umbilical endometriosis after unprotected removal of uterine pieces through the umbilicus. J Am Assoc Gynecol Laparosc 7: 227–232 Koninckx PR, Martin D (1997) Surgical treatment of deeply infiltrating endometriosis. In: Sutton GJG (ed) Gynecological endoscopic surgery. Chapman & Hall Medical, London, pp 19–35 Marcoux S, Maheux R, Berube S, Canadian Collaborative Group on Endometriosis (1997) Laparoscopic surgery in infertile women with minimal or mild endometriosis. N Engl J Med 337: 217–222 Possover M, Diebolder H, Plaul K, Schneider A (2000) Laparoscopically assisted vaginal resection of rectovaginal endometriosis. Obstet Gynecol 96: 304–307 Redwine DB (1991) Conservative laparoscopic excision of endometriosis by sharp dissection: life table analysis of reoperation and persistent or recurrent disease. Fertil Steril 56: 628–634 Turnwald W, Egger H, Weiß S (1998) Radikale operative Behandlung der Endometriose mit Darmteilresektion. Geburtsh Frauenheilk 58:415–419 Wheeler JM, Malinak LR (1989) The surgical management of endometriosis. Obstet Gynecol Clin North Am 16:147–156 Author information Authors and Affiliations Editor information Editors and Affiliations Rights and permissions Copyright information © 2003 Springer-Verlag Berlin Heidelberg About this paper Cite this paper Schneider, A., Kavallaris, A., Klemm, P., Kühne-Heid, R., Köhler, C. (2003). Endometriose des Septum rectovaginale: Histopathologische Rechtfertigung für die Darmresektion. In: Bender, H.G., Dall, P. (eds) 54. Kongress der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-18257-0_43 Download citation DOI: https://doi.org/10.1007/978-3-642-18257-0_43 Publisher Name: Springer, Berlin, Heidelberg Print ISBN: 978-3-642-62125-3 Online ISBN: 978-3-642-18257-0 eBook Packages: Springer Book Archive

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