Laparoscopic Surgery for Rectovaginal Endometriosis: A Retrospective Descriptive Study from a Single Centre

Igno Siebert, K. van der Merwe, Matt S. Gooding, Thinus F. Kruger, Catherine Cluver, Cathy A. Cluver
In: Journal of Endometriosis and Pelvic Pain Disorders · 2016 · vol. 8(1) , pp. 8–12 · doi:10.5301/je.5000237 · W319722251
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Abstract

Introduction Rectovaginal endometriosis is a form of deep infiltrating endometriosis and accounts for 5%-10% of cases. It is a very difficult to treat and can be associated with severe complications. Objectives The aim was to document the outcomes of patients undergoing laparoscopic surgery for rectovaginal endometriosis. Methods A retrospective audit of 112 consecutive women undergoing laparoscopic surgery for rectovaginal endometriosis at Vincent Pallotti's Aevitas Fertility Clinic was undertaken. Women were identified from a surgical database using medical aid coding and a review of case notes. Patients were telephonically contacted to gather missing information and to assess further outcomes. Results The majority of surgeries were performed using the shaving technique, in keeping with international trends, whilst fourteen cases required a segmental resection owing to extensive disease. Complications included rectovaginal fistulas (3 cases), bowel injuries (2 cases), ureteric injury (1 case), a pelvic abscess (1 case), a blood transfusion (1 case) and the need for three urgent re-operations. Of the 71 patients desiring fertility, 39 (54.9%) fell pregnant. Twenty-seven (69.2%) were spontaneous conceptions. Conclusions Our outcomes are in keeping with complication rates quoted in the international literature. In trained hands, laparoscopic surgery at our unit is a valid option in the management of rectovaginal endometriosis with similar complication rates and outcomes to international standards.

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endometriosisdie_deep_infiltratingbowel_endometriosis

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