Laparoscopic Treatment of Retrovaginal Septum Endometriosis

Objective To evaluate the feasibility and efficacy of laparoscopic excision of retrovaginal septum endometriosis.Methods A total of seventeen cases with retrovaginal septum endometriosis were included in this retrospective study between May 1995 and December 2010.Five cases were received abdominal or vaginal operations(abdominal/vaginal group) and twelve cases were received laparoscopic operations(laparoscopic group).The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Peking University First Hospital.Informed consent was obtained from all participants.Results In the abdominal/vaginal surgery group,the mean operation time was 105 min(25 min to 276 min),and the mean blood loss volume was 464 mL(50 mL to 2000 mL).After operation,the pelvic pain was relieved in 4 cases,the sexual intercourse pain recurred in 1 case,rectal irritation symptom was partly relieved in 1case.Whereas,in laparoscopy group,the mean operation time was 188 min(70 min to 360 min),and the mean blood loss volume was 153 mL(20 mL to 1500 mL).Rectal muscular injury happened in one case.After operation,the pelvic pain was relieved in 8 cases(partly relieved in 2 cases),the rectal irritation symptom was partly relieved in 4 cases.A successful pregnancy after the nine months of trying the operation.Conclusion Laparoscopic excision of retrovaginal septum endometriosis was feasible and can effectively relieve pain symptom.However,large randomized controlled studies would be required to validate this approach.