Analysis of Clinical Characteristics of 11 Patients with Rectovaginal Septum Endometriosis

Objective:To evaluate the clinical characteristics of rectovaginal septum endometriosis(EMT)and the value of laparoscopy for its diagnosis and treatment.Methods:The clinical data of 11 rectovaginal septum EMT patients who were treated with laparoscope and confirmed by histology in past 6 years were retrospectively analyzed.Results:9 patients presented with dysmenorrhea and 6 cases presented with bowel symptoms.The lesions with obvious tenderness located in the rectovaginal septum,ranging from 10 to 70 mm in diameter,solid,hard,and unmoved.Preoperative diagnosis of 2 cases depended on the vaginal biopsy and 7 cases were highly suspected diagnosis,as well as 2 cases were misdiagnosed.All cases were confirmed by laparoscopy and underwent laparoscopic resection of EMT lesion,of which 7 and 9 patients were underwent preoperative and postoperative hormonotherapy,respectively.During the followed-up,11 cases(100%)achieved symptom remission,and 1 case got recurrence of ovarian EMT cyst.1 infertile case got pregnany 6 months later.Significant differences in the quality of life scores and the visual analogue scale were observed before surgery to after surgery(P0.05).The rectal seromuscular layer was injured in 3 cases in surgery,and postoperative fever was observed in 2 cases,and rectovaginal leakage and the stool shapeless was observed in 1 case,respectively.Conclusions:Rectovaginal septum EMT clinically presented with various pelvic pain and bowel symptoms.the lesions located in the rectovaginal septum with tenderness.Preoperative diagnosis depends on the medical history,gynecological examination and laboratory examinations.Laparoscopic surgery can remove all visible lesions,and postoperative hormonotherapy has some values in improvement of the postoperative prognosis.