Surgical treatment of symptomatic rectosigmoid endometriosis.
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Surgical treatment for rectosigmoid endometriosis, involving hysterectomy or oophorectomy and bowel resection, successfully relieved symptoms in 64% of patients after conservative treatment failed.
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Abstract
OBJECTIVE: To assess the results of surgical treatment of symptomatic intestinal endometriosis. DESIGN: Retrospective study. SETTING: University hospital, The Netherlands. SUBJECTS: 14 patients in whom medical treatment had failed. INTERVENTIONS: Hysterectomy (n = 5), salpingo-oophorectomy (n = 8, bilateral in 5), posterior vaginal wall excision (n = 14), and partial resection (n = 6) or anterior wedge excision (n = 8) of the rectum. MAIN OUTCOME MEASURES: Blood loss, operating time, morbidity, and relief of symptoms. RESULTS: 9 patients became symptom free (64%), 5 of whom developed postmenopausal symptoms later on. 2 had unrelated vague abdominal symptoms and 3 more could not be assessed because they underwent in vitro fertilisation and developed stimulation-related abdominal symptoms. All were content with the operative results. CONCLUSIONS: Operations for rectosigmoid endometriosis are technically difficult with a long operating time and considerable blood loss, but they are successful in relieving symptoms when conservative treatment has failed.
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