Index

Rectovaginal endometriosis is perhaps the greatest gynecological surgical challenge, exceeding the complexity of gynecologic oncological surgery. If such disease represented cancer, it would be deemed inoperable, whereas endometriosis is benign and locally invasive and the only effective treatment is excision. The gold standard effective treatment is surgical removal of the disease from the body. Many have a long history of subfertility.1 For the majority of women of childbearing age surgery can be accomplished with preservation of the uterus and adnexae. Pelvic endometriosis affects 5-7% of menstruating women.1 The incidence of bowel involvement however varies greatly because of methods of case selection, with a reported incidence of between 3% and 34%.