Histopathological extent of rectal invasion by rectovaginal endometriosis

A Kavallaris, Andreas Kavallaris, Kavallaris A, C Köhler, Köhler C, Kühne-Heid R, R Kühne-Heid, Schneider A, A Schneider
Human Reproduction · 2003 · vol. 18(6) , pp. 1323–1327 · doi:10.1093/humrep/deg251 · PMID:12773467 · W2115765653
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This study evaluated the histopathological extent of rectovaginal endometriosis in en-bloc surgical specimens, finding involvement of the serosa and muscularis propria in all patients, submucosa in 34%, and mucosa in 10%.

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Abstract

BACKGROUND: We aimed to evaluate the microscopic extent of endometriosis in surgical en-bloc specimens of vaginal skin, rectovaginal septum, cul-de-sac, and part of the rectosigmoid bowel. METHODS: From December, 1997 to October, 2001, 50 patients with the trias of intestinal pain, palpable disease in the rectovaginal septum, and laparoscopic diagnosis of endometriosis of the cul-de-sac and/or rectosigmoid colon underwent combined laparoscopic-vaginal en-bloc resection of the cul-de-sac with partial resection of the posterior vaginal wall and rectum with reanastomosis by minilaparotomy. All surgical specimens were histopathologically evaluated in a standardized fashion. RESULTS: The mean length of the bowel specimen was 7.48 cm. Endometriosis involved the serosa and muscularis propria in all patients, the submucosa in 17 patients (34%), and the mucosa in five patients (10%). After a mean follow-up of 32 months, 90% of patients reported a considerable improvement or were completely free of symptoms and the rate of recurrence was 4% (two patients). CONCLUSIONS: Partial bowel resection indicates the depth and multifocality of endometriosis affecting the recto-sigmoid colon. Such extensive surgery appears justified by the extent of the lesions and the long-term relief of symptoms achieved.

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Condition tags

endometriosisbowel_endometriosis

MeSH descriptors

Endometriosis Rectal Diseases Rectum Vaginal Diseases Adult Adult Colon, Sigmoid Colon, Sigmoid Colon, Sigmoid Endometriosis Endometriosis Endometriosis Female Female Humans Humans Laparoscopy Laparoscopy Mucous Membrane Mucous Membrane

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References (22)

Cited by (50)

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